保留盆神经丛的宫颈癌根治术对膀胱与结直肠功能恢复的影响研究

Effect of cervical cancer radicalization with preservation of pelvic plexus on recovery of bladder and colorectal function

目的总结实施保留盆神经丛宫颈癌根治术的早期宫颈癌患者临床病例资料,并分析其对膀胱与结直肠功能恢复的改善情况。方法收集我院近五年来(2013年1月～2017年12月)诊治的早期宫颈癌(2009FIGO分期:ⅠB～ⅡA)患者临床资料,研究组(n=28)为保留盆神经丛宫颈癌根治术病例,对照组(n=41)为传统术式病例,回顾性比较、分析保留神经术式对膀胱与结直肠功能恢复的影响情况。结果研究组平均住院日较对照组更少(P<0.05),手术时间更长(P<0.05);研究组的残余尿合格率较对照组更高(P<0.05),尿频发生率较更低(P<0.05);研究组术后排气时间较对照组更短(P<0.05),里急后重发生率也更少,差异均有统计学意义(P<0.05);其余观察指标比较差异无统计学意义(P>0.05)。结论保留盆神经丛的腹腔镜下宫颈癌根治术在保证手术范围同时能够减少手术对膀胱和结直肠功能的影响,推荐在熟知解剖、掌握适应证的条件下开展实施。

Objective To summarize the clinical data of patients with early cervical cancer undergoing radicalization with preservation of pelvic plexus and to analyze its effect on recovery of bladder and colorectal function. Methods The clinical data of patients with early cervical cancer(2009FIGO stage:ⅠB~ⅡA) diagnosed and treated in our hospital in the past five years(January 2013 to December 2017) were collected. The study group(n=28) was given radical resection of cervical cancer with preserved pelvic plexus. The control group(n=41) was performed in the traditional procedure. The effects of the two procedures on bladder and colorectal function recovery were compared and analyzed. Results The average hospitalization time of the study group was shorter than that of the control group(P<0.05), and the operation time was longer(P<0.05). The qualified rate of residual urine of the study group was higher than that of the control group(P<0.05), and the incidence of urinary frequency was lower(P<0.05);the postoperative exhaust time of the study group was shorter than that of the control group(P<0.05), and the incidence of tenesmus was lower(P<0.05);There was no other statistical significance(P>0.05). Conclusion Cervical cancer radicalization with preservation of pelvic plexus can reduce the impacts on bladder and colorectal function with insurance of the scope of surgery, thus it is recommended when possible.