保留盆腔自主神经的广泛子宫切除术对早期宫颈癌患者T淋巴细胞亚群、膀胱功能及直肠功能的影响

Effects of extensive hysterectomy with preservation of pelvic autonomic nerve on T lymphocyte subsets,bladder function and rectal function in patients with early cervical cancer

目的探讨保留盆腔自主神经的广泛子宫切除术对早期宫颈癌患者T淋巴细胞亚群、膀胱功能及直肠功能的影响。方法根据手术方式的不同将97例宫颈癌患者分为观察组(n=50)和对照组(n=47),对照组患者给予传统的广泛子宫切除术,观察组患者给予保留盆腔自主神经的广泛子宫切除术。比较两组患者的T淋巴细胞亚群水平(CD3^(+)、CD4^(+),计算CD4^(+)/CD8^(+))、膀胱功能指标(术后残余尿量﹤100 ml时间、术后残余尿量﹤50 ml时间)、直肠功能指标(术后肛门排气时间、术后排便时间)和并发症发生情况。结果术后,两组患者CD3^(+)、CD4^(+)水平和CD4^(+)/CD8^(+)均低于本组术前,但观察组患者CD3^(+)、CD4^(+)水平和CD4^(+)/CD8^(+)均高于对照组,差异均有统计学意义(P﹤0.05)。观察组患者术后残余尿量﹤100 ml时间、术后残余尿量﹤50 ml时间、术后肛门排气时间、术后排便时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。观察组患者的并发症总发生率为8.00%,低于对照组患者的23.40%,差异有统计学意义(P﹤0.05)。结论保留盆腔自主神经的广泛子宫切除术可明显减轻对早期宫颈癌患者T淋巴细胞亚群的影响,有利于患者术后膀胱、直肠功能的恢复,且该术式安全性较高。

Objective To investigate the effect of extensive hysterectomy with preservation of pelvic autonomic nerve on T lymphocyte subsets,bladder function and rectal function in patients with early cervical cancer.Method A to-tal of 97 patients with cervical cancer were divided into observation group(n=50)and control group(n=47)according to different surgical methods.Patients in the control group were given the traditional extensive hysterectomy,while the ob-servation group were given extensive hysterectomy with preservation of pelvic autonomic nerves.The levels of T lympho-cyte subsets(CD3^(+),CD4^(+),CD4^(+)/CD8^(+)),bladder function indexes(postoperative residual urine volume<100 ml time,post-operative residual urine volume<50 ml time),and rectal function indexes(postoperative anal exhaust time,postoperative defecation time),and complications were compared between the two groups.Result After operation,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the two groups were lower than those before operation,and the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,but the differences were statistically signifi-cant(P<0.05).The postoperative residual urine volume<100 ml time,postoperative residual urine volume<50 ml time,postoperative anal exhaust time,postoperative defecation time in the observation group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.01).The total incidence of complications in the observation group was 8.00%,which was lower than 23.40%in the control group,and the difference was statistical-ly significant(P<0.05).Conclusion Extensive hysterectomy with preservation of pelvic autonomic nerve can significant-ly reduce the impact on T lymphocyte subsets in patients with early cervical cancer,which is beneficial to the recovery of postoperative bladder and rectal functions,and the operation is safe.