腹腔镜下保留神经平面广泛性子宫切除术在宫颈癌患者中的应用效果

Application effect of laparoscopic extensive nerve-sparing radical hysterectomy in patients with cervical cancer

目的探讨腹腔镜下保留神经平面广泛性子宫切除术在宫颈癌患者中的应用效果。方法根据手术方式的不同将80例宫颈癌患者分为对照组(n=40)和观察组(n=40),对照组患者行开腹保留神经平面广泛性子宫切除术,观察组患者行腹腔镜下保留神经平面广泛性子宫切除术。比较两组患者的手术相关指标、血清前梯度蛋白2(AGR2)水平、血清结缔组织生长因子(CTGF)水平、生活质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]及并发症发生情况。结果观察组患者的手术时间明显长于对照组,肛门排气时间、术后自主下床活动时间、术后住院时间均明显短于对照组,术中出血量明显少于对照组,差异均有统计学意义(P﹤0.01)。术后,两组患者血清AGR2水平均低于本组术前,血清CTGF水平均高于本组术前,观察组患者血清AGR2水平低于对照组,血清CTGF水平高于对照组,差异均有统计学意义(P﹤0.05)。术后,两组患者EORTC QLQ-C30各维度评分均高于本组术前,观察组患者EORTC QLQ-C30各维度评分均高于对照组,差异均有统计学意义(P﹤0.05)。观察组患者的并发症总发生率低于对照组,差异有统计学意义(P﹤0.05)。结论腹腔镜下保留神经平面广泛性子宫切除术能够缩短宫颈癌患者的住院时间,促进患者术后恢复,提高生活质量,改善肿瘤因子水平,降低并发症发生率。

Objective To investigate the application effect of laparoscopic extensive nerve-sparing radical hysterectomy in patients with cervical cancer.Method A total of 80 cervical cancer patients were divided into control group(n=40)and observation group(n=40)according to different surgery methods.Patients in the control group underwent extensive nerve-sparing radical hysterectomy under laparotomy,while patients in the observation group underwent laparoscopic extensive nerve-sparing radical hysterectomy.The surgery-related indicators,serum anterior gradient 2(AGR2)level,serum connective tissue growth factor(CTGF)level,quality of life[European Organization for Research and Treatment of Cancer quality of life questionnaire core 30(EORTC QLQ-C30)],and the occurrence of complications were compared between the two groups.Result The operation time of the observation group was significantly longer than that of the control group,the anal exhaust time,postoperative voluntary out-of-bed time,and postoperative hospital stay were significantly shorter than those of the control group,the intraoperative blood loss was significantly less than that of the control group,and the differences were statistically significant(P<0.01).After the surgery,the serum AGR2 levels of the two groups were lower than those before the surgery,and the serum CTGF levels were higher than those before the surgery,the serum AGR2 level of the observation group was lower than that of the control group,and the serum CTGF level was higher than that of the control group,and the differences were statistically significant(P<0.05).After the surgery,the scores of each dimension of EORTC QLQ-C30 in the two groups were higher than those before the surgery,and the scores in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The total incidence rate of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic extensive nerve-sparing radical hysterectomy could shorten the length of hospital stay,promote postoperative recovery,improve the quality of life,control tumor factor levels,and reduce the incidence of complications in patients with cervical cancer.