腹腔镜下保留盆腔自主神经广泛性子宫切除术治疗宫颈癌患者的效果

Effects of laparoscopic pelvic autonomic nerve-sparing radical hysterectomy in the treatment of cervical cancer patients

目的:观察腹腔镜下保留盆腔自主神经广泛性子宫切除术治疗宫颈癌患者的效果。方法:选取2020年1月至2023年1月该院收治的68例宫颈癌患者进行前瞻性研究,按照随机数字表法将其分为研究组与对照组各34例。对照组采用常规腹腔镜下广泛性子宫切除术治疗,研究组采用腹腔镜下保留盆腔自主神经广泛性子宫切除术治疗,比较两组尿动力学参数(残余尿量、最大尿流率和最大尿道压)、并发症发生率、卡氏评分和人乳头瘤病毒(HPV)载量。结果:术后7 d,两组最大尿流率和最大尿道压均高于术前,且研究组高于对照组,两组残余尿量均低于术前,且研究组低于对照组,差异有统计学意义(P<0.05);住院期间,研究组并发症发生率为8.82%,明显低于对照组的29.41%,差异有统计学意义(P<0.05);术后7 d,两组卡氏评分高于术前,且研究组高于对照组,差异均有统计学意义(P<0.05);术前、术后7 d,两组HPV载量比较,差异均无统计学意义(P>0.05)。结论:腹腔镜下保留盆腔自主神经广泛性子宫切除术治疗宫颈癌患者可提高卡氏评分,改善尿动力学参数,以及降低并发症发生率,效果优于常规腹腔镜下广泛性子宫切除术治疗。

Objective:To observe effects of laparoscopic pelvic autonomic nerve-sparing radical hysterectomy in the treatment of cervical cancer patients.Methods:A prospective study was conducted on 68 patients with cervical cancer admitted to this hospital from January 2020 to January 2023.They were divided into study group and control group according to the random number table method,34 cases in each group.The control group was treated with conventional laparoscopic radical hysterectomy,while the study group was treated with laparoscopic pelvic autonomic nerve-sparing radical hysterectomy.The urodynamic parameter levels(residual urine volume,maximum urinary flow rate and maximum urethral pressure),the incidence of complications,the Karnofsky score,and the human papillomavirus(HPV)viral load were compared between the two groups.Results:7 days after the surgery,the maximum urinary flow rate and the maximum urethral pressure in the two groups were higher than those before the surgery,and those in the study group were higher than those in the control group;the residual urine volume of the two groups was lower than that before the surgery,and that in the study group was lower than that in the control group;and the differences were statistically significant(P<0.05).During the hospitalization,the incidence of complications in the study group was 8.82%,which was significantly lower than 29.41%in the control group,the difference was statistically significant(P<0.05).7 days after the surgery,the Karnofsky scores of the two groups were higher than those before the surgery,that in the study group was higher than that in the control group,and the differences were statistically significant(P<0.05).However,there were no significant differences in the HPV viral load between the two groups before and 7 days after the surgery(P>0.05).Conclusions:Laparoscopic pelvic autonomic nerve-sparing radical hysterectomy for the cervical cancer patients can increase the Karnofsky scores,improve the urodynamic parameter levels,and reduce the incidence of complications.Moreover,it is superior to conventional laparoscopic radical hysterectomy.