腹腔镜联合淋巴结切除术治疗卵巢癌的疗效及对性功能的影响

Effect of laparoscopy combined lymphadenectomy in patients with ovarian cancer and its influence on sexual function

目的探讨腹腔镜联合淋巴结切除术治疗卵巢癌的疗效及对性功能的影响。方法采用随机数字表法将85例卵巢癌患者分为观察组43例和对照组42例。对照组采用开腹手术治疗,观察组采用腹腔镜联合淋巴结切除术治疗,比较两组患者性功能、卵巢功能、并发症及远期复发率。结果术后3个月,两组患者阴道动态压力、盆底Ⅰ类纤维肌力、盆底Ⅱ类纤维肌力及女性性功能量表(BISF-W)评分均高于术前,且观察组阴道动态压力、盆底Ⅰ类纤维肌力、盆底Ⅱ类纤维肌力及BISF-W评分均高于对照组,差异均有统计学意义(P﹤0.05)。术后3个月,两组患者卵巢横截面积、阻力指数(RI)均降低,收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)均升高,但观察组患者卵巢横截面积、RI均高于对照组,PSV、EDV均低于对照组,差异均有统计学意义(P﹤0.05)。两组患者切口感染、淋巴囊肿、肠麻痹发生率及术后6、12、18个月复发率比较,差异均无统计学意义(P﹥0.05)。结论腹腔镜联合淋巴结切除术治疗卵巢癌,对患者性功能及卵巢功能影响较小,手术安全性较高,且能降低远期复发率,值得推广应用。

Objective To investigate the curative effect of laparoscopy combined lymphadenectomy in patients with ovarian cancer and its influence on sexual function.Method A total of 85 patients with ovarian cancer were divided into two groups by random number table,42 cases in the control group were treated with open surgery,and 43 cases in the observation group were treated with laparoscopy combined lymphadenectomy.The sexual function,ovarian function,complications and long-term recurrence rate were compared between the two groups.Result Three months after surgery,the dynamic vaginal pressure,pelvic floor type I and pelvic floor type II fiber muscle strength and brief index of sexual function for women(BISF-W)scores in two groups were higher than those before surgery,with higher scores in the observation group than those in the control group(P<0.05).Three months after surgery,ovarian cross-sectional area and resistance index(RI)decreased and peak systolic blood flow velocity(PSV)and end-diastolic blood flow velocity(EDV)increased than those before surgery,with higher ovarian cross-sectional area and RI and lower PSV and EDV than those in the control group(P<0.05).There were no significant differences for incidence of incision infection,lymphatic cyst,intestinal paralysis and the recurrence rate at 6,12,18 months after surgery in both groups(P>0.05).Conclusion Laparoscopy combined lymphadenectomy for patients with ovarian cancer has little effect on sexual function and ovarian function,the operation is safer and can reduce the long-term recurrence rate,which is worthy of application.