腹腔镜下早期宫颈癌患者根治术后盆腔功能及性功能状况分析

Analysis of the pelvic function and sexual function after laparoscopic radical resection of patients with early stage cervical cancer

目的探讨腹腔镜下早期宫颈癌患者根治术后对患者盆腔功能及性功能的影响。方法选取2015年12月至2016年11月海南医学院第二附属医院妇科诊治的92例宫颈癌患者为研究对象,采用随机数表法将其平均分为观察组和对照组,每组46例患者。观察组患者给予腹腔镜手术治疗,对照组患者给予传统开腹手术治疗。比较两组患者治疗后相关手术指标变化情况、并发症发生率、性功能、盆腔功能改善情况以及满意度情况。结果两组患者的手术时间、淋巴结清扫数比较,其差异均无统计学意义(均P>0.05);观察组患者的术中出血量、术后盆腔引流量(312.02±21.56ml、126.78±12.56ml)均低于对照组患者(332.78±22.58ml、220.15±32.02ml),其差异均具有统计学意义(均P<0.05);观察组患者的术后下床活动时间[(42.13±6.02)h]短于对照组患者[(56.12±6.68)h],其差异具有统计学意义(P<0.05)。观察组患者的术后住院时间、术后肛门排气时间[(9.56±2.60)d、(28.12±3.29h)]均短于对照组患者[(12.12±3.78)d、(36.12±5.02)h],其差异均具有统计学意义(均P<0.05);治疗后观察组患者并发症总发生率(13.0%)低于对照组患者(37.1%),其差异具有统计学意义(P<0.05);观察组患者的性欲、性唤起、性心理、射精时间和性行为异常症状评分情况均明显优于对照组患者,其差异均具有统计学意义(均P<0.05);观察组患者的满意率(91.3%)高于对照组患者(76.1%),其差异具有统计学意义(P<0.05)。两组患者治疗后的阴道静息压(Vaginal resting pressure,VRP)、阴道收缩压(Vaginal systolic pressure,VSP)均有所提高,观察组患者高于对照组患者,其差异均具有统计学意义(均P<0.05)。结论采用腹腔镜手术治疗早期宫颈癌,对患者产生的创伤小,患者术后恢复快,降低了患者并发症发生率,改善了患者的性功能和盆腔功能,取得了显著的临床效果。

Objective To investigate the effect of laparoscopic radical resection on the pelvic function and sexual function of patients with early stage cervical cancer. Methods 92 patients with cervical cancer treated in our hospital from December 2015 to November 2016 were selected. By using a random number table method all the patients were divided into two groups, with 46 cases in each group. The control group was given traditional open surgery, and the observation group was treated with laparoscopic surgery. The changes in related surgical indexes, complication rate, sexual function, improvement in and satisfaction of pelvic function between the two groups after treatment were observed and compared. Results There were no statistically significant differences in the operation time, lymph nodes between the two groups(all P>0.05). The intraoperative blood loss and postoperative pelvic drainage [(312.02±21.56)ml,(126.78±12.56)ml] of observation group was lower than that of control group [(332.78±22.58)ml,(220.15±32.02)ml], with statistically significant differences(all P<0.05). The time of ambulation after operation [(42.13±6.02)h] in observation group was earlier than that in control group [(56.12±6.68)h], with statistically significant difference(P<0.05). The postoperative hospital stay, postoperative anal exhaust time [(9.56±2.60)d,(28.12±3.29)h] of observation group was shorter than that of control group [(12.12±3.78)d,(36.12±5.02)h], with statistically significant differences(all P<0.05). After treatment, the total complication rate of observation group(13.0%) was lower than that of control group(37.0%), with statistically significant difference(P<0.05). After treatment, sexual desire, sexual psychology, sexual arousal, ejaculation time and abnormal sexual behavior symptom scores of observation group were significantly better than these of control group, with statistically significant differences(all P<0.05). The satisfaction rate of observation group(91.3%) after treatment was higher than that of control group(76.1%), with statistically significant difference(P<0.05). The vaginal resting pressure(VRP) and vaginal systolic pressure(VSP) of the two groups were improved after treatment and that of the observation group was higher than that of the control group, with statistically significant difference(all P<0.05). Conclusions Laparoscopic surgery can reduce the incidence of complications and improve sexual function and pelvic function of patients with early cervical cancer, which causes little trauma to patients with quick recovery after surgery.