保留盆腔自主神经宫颈癌根治术和广泛性子宫切除术对宫颈癌患者术后膀胱、直肠和性功能的影响

Effects of Pelvic Autonomic Nerve-Sparing Radical Surgery for Cervical Cancer and Extensive Hysterectomy on Postoperative Bladder,Rectal and Sexual Function in Treatment of Patients with Cervical Cancer

目的探讨保留盆腔自主神经宫颈癌根治术和广泛性子宫切除术对宫颈癌患者术后膀胱、直肠和性功能的影响。方法选取2014年12月-2019年12月收治的宫颈癌90例,根据手术方法不同将其分为观察组(48例)和对照组(42例)两组,观察组行保留盆腔自主神经宫颈癌根治术,对照组行广泛性子宫切除术。比较两组手术相关情况,术后膀胱和直肠功能,术后住院期间并发症发生情况,以及术后6个月性功能。结果观察组手术时间长于对照组,术后拔除导尿管时间、排气时间和排便时间短于对照组,术后残余尿量、膀胱最大容量、最大尿流率及术后住院期间消化系统并发症发生率低于对照组,术后住院期间总并发症发生率低于对照组,术后6个月女性性功能指数量表性欲望、性唤起、性润滑、性高潮、性满意、性交痛维度评分和总评分均高于对照组,差异有统计学意义(P<0.05或P<0.01)。结论相较于广泛性子宫切除术,宫颈癌患者行保留盆腔自主神经宫颈癌根治术有利于术后膀胱和直肠功能恢复,还能减少术后并发症,且对患者性功能影响较小。

Objective To explore effects of pelvic autonomic nerve-sparing radical surgery for cervical cancer and extensive hysterectomy on postoperative bladder,rectal and sexual function in treatment of patients with cervical cancer.Methods A total of 90 patients with cervical cancer admitted between December 2014 and December 2019 were selected,and the patients were divided into observation group(n=48)and control group(n=42)according to the different surgical methods.Observation group received pelvic autonomic nerve-sparing radical surgery for cervical cancer,while control group received extensive hysterectomy.Surgery-related conditions,postoperative bladder and rectal function,incidence rates of complications during postoperative hospitalization and sexual function after surgery for 6 months were compared between two groups.Results In observation group,surgical duration was longer than that in control group,while postoperative catheter removal time,exhaust time and defecation time were shorter than those in control group;postoperative residual urine volume,maximum bladder volume,maximum urine flow rate and incidence rates of digestive system complications during postoperative hospitalization were lower than those in control group,and the total incidence rate of complications during postoperative hospitalization was lower than that in control group;dimension scores of sexual desire,sexual arousal,sexual lubrication,orgasm,sexual satisfaction and algopareunia and the total score of Female Sexual Function Index Scale after surgery for 6 months were higher than those in control group,and the differences were statistically significant(P<0.05 or P<0.01).Conclusion Pelvic autonomic nerve-sparing radical surgery for cervical cancer is more conducive to the recovery of postoperative bladder and rectal function,and it may reduce incidence rates of postoperative complications with less effect on sexual function of patients compared with those by extensive hysterectomy in treatment of patients with cervical cancer.