腹腔镜广泛全子宫切除术与开腹广泛全子宫切除术治疗早期宫颈癌的效果对比

Effect Comparison of Laparoscopic Extensive Hysterectomy and Open Extensive Total Hysterectomy in the Treatment of Early Cervical Cancer

目的:研究腹腔镜广泛全子宫切除术和开腹广泛全子宫切除手术对早期宫颈癌患者的治疗效果。方法:选取2017年2月-2018年6月中山市三乡医院收治的早期宫颈癌患者96例,以随机数字表法分成观察组与对照组,各48例。对照组予以开腹广泛全子宫切除手术治疗,观察组则予以腹腔镜下保留盆腔自主神经的广泛性子宫切除术治疗。比较两组的手术指标、术后膀胱功能等。结果:两组的手术时间、术中失血量、阴道切除长度、淋巴结切除数量比较,差异均无统计学意义(P>0.05)。观察组术后膀胱功能障碍、腹压排尿以及尿潴留发生率均明显低于对照组,差异均有统计学意义(P<0.05)。两组术后尿流动力学各相关指标水平与术前比较,差异均有统计学意义(P<0.05);且术后观察组膀胱顺应性、最大逼尿肌收缩压、最大尿流率水平均明显高于对照组,差异均有统计学意义(P<0.05)。结论:相比于开腹广泛全子宫切除手术治疗,腹腔镜广泛全子宫切除术可有效降低对早期宫颈癌患者膀胱与排尿功能的影响。

Objective:To study the effect of laparoscopic extensive hysterectomy and open extensive total hysterectomy on patients with early cervical cancer.Method:From February 2017 to June 2018,96 patients with early cervical cancer admitted to Sanxiang Hospital of Zhongshan City were selected.They were divided into the observation group and the control group according to the random number method,48 cases in each group.The control group was treated with open extensive total hysterectomy,while the study group was treated with laparoscopic extensive hysterectomy that retained the pelvic autonomic nerve.The operative indexes and postoperative bladder function of the two groups were compared.Result:The duration of surgery,intraoperative blood loss,length of vaginal resection and number of lymph nodes were compared between the two groups,the differences were not statistically significant(P>0.05).The incidence of postoperative bladder dysfunction,abdominal pressure and urinary retention in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).The differences in the levels of various indicators of postoperative urodynamics between the two groups were statistically significant compared with those before surgery(P<0.05);bladder compliance,maximum detrusor systolic pressure,and maximum urine flow rate in the observation group were significantly higher than those in the control group,with statistically significant differences(P<0.05).Conclusion:Compare with open extensive total hysterectomy,laparoscopic extensive hysterectomy can effectively reduce the impact on the bladder and micturition function of patients with early cervical cancer.