保留盆腔自主神经的广泛子宫切除术对子宫颈癌患者的影响

Effects of Extensive Hysterectomy with Preservation of Pelvic Autonomic Nerves on Patients with Cervical Cancer

目的:研究保留盆腔自主神经的广泛子宫切除术对子宫颈癌患者的影响。方法:选取2015年2月-2018年2月深圳市宝安区松岗人民医院收治的子宫颈癌患者86例为研究对象。根据随机数字表法将其分为试验组与对照组,各43例。对照组予以常规广泛子宫切除术联合盆腔淋巴结清扫术(PLND)治疗,试验组予以保留盆腔自主神经的广泛子宫切除术联合PLND治疗。比较两组手术指标,膀胱及直肠功能,术前1 d及术后6个月的卵巢功能,术后复发率与死亡率。结果:试验组术后住院时间短于对照组(P<0.05);试验组术后残余尿<50 ml时间、残余尿<100 ml时间,术后排气时间、术后排便时间均早于对照组(P<0.05);术后6个月,试验组血清雌二醇(E_(2))水平相比对照组较高,而血清促黄体生成素(LH)及促卵泡激素(FSH)水平均相比对照组较低(P<0.05);两组术后复发率与死亡率对比差异均无统计学意义(P>0.05)。结论:保留盆腔自主神经的广泛子宫切除术有利于改善患者的盆底功能及卵巢功能,且有效缩短住院时间,值得临床推广应用。

Objective:To study the effect of extensive hysterectomy with preservation of pelvic autonomic nerve on patients with cervical cancer.Method:A total of 86 cases with cervical cancer admitted to Bao’an District Songgang People’s Hospital of Shenzhen from February 2015 to February 2018 were selected as the research subjects.They were divided into experimental group and control group according to the random number table method,43 cases in each group.The control group was given the treatment of conventional extensive hysterectomy combined with pelvic lymph node dissection (PLND),and the experimental group was given the treatment of extensive hysterectomy with preservation of pelvic autonomic nerve combined with PLND.The surgical indexes,bladder and rectal function,ovarian function 1 day before and 6 months after surgery,postoperative recurrence rate and mortality were compared between the two groups.Result:The postoperative hospitalization time of the experimental group was shorter than that of control group (P<0.05);the postoperative residual urine < 50 ml,residual urine < 100 ml time,postoperative exhaust time and postoperative defecation time of the experimental group were earlier than those of the control group (P<0.05);six months after surgery,serum estradiol (E_(2)) level in experimental group was higher than that in control group,while serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels in experimental group were lower than those in control group (P<0.05);there were no significant differences in postoperative recurrence rate and mortality between the two groups (P>0.05).Conclusion:Extensive hysterectomy with preservation of pelvic autonomic nerve is beneficial to improve pelvic floor function and ovarian function of patients,and effectively shorten the hospital stay.It is worthy of clinical promotion and application.