广泛性子宫切除术联合盆腔淋巴结清扫术对宫颈癌患者盆底功能的影响研究

Effect of extensive hysterectomy combined with pelvic lymph node dissection on pelvic floor function in patients withcervicalcancer

目的探讨广泛性子宫切除术联合盆腔淋巴结清扫术对宫颈癌患者盆底功能的影响。方法选取122例宫颈癌患者,按照治疗方法不同将其分为对照组(采用广泛性子宫切除术)与研究组(采用广泛性子宫切除术+盆腔淋巴结清扫术),每组61例。对比两组患者手术前后盆底功能障碍性疾病发生情况、术后自由尿流率指标及盆底电生理功能指标。结果研究组尿失禁、便失禁发生率分别为24.59%、16.39%,均高于对照组的9.84%、4.92%(P<0.05)。两组排尿时间、达峰时间、平均尿流率、最大尿流率比较,差异无统计学意义(P>0.05)。研究组肌电位、Ⅰ类与Ⅱ类肌纤维肌力及纤维疲劳度指标均低于对照组(P<0.05)。结论广泛性子宫切除术联合盆腔淋巴结清扫术会对盆底功能造成损伤。

Objective To investigate the effect of extensive hysterectomy combined with pelvic lymph node dissection on pelvic floor function in patients with cervical cancer.Methods 122 patients with cervical cancer were selected and divided into control group(extensive hysterectomy)and study group(extensive hysterectomy+pelvic lymph node dissection)according to different treatment methods,with 61 cases in each group.The incidence of pelvic floor dysfunction,postoperative free urine flow rate and pelvic floor electrophysiological function were compared between the two groups.Results The incidence of urinary incontinence and fecal incontinence in the study group were 24.59%and 16.39%,respectively,which were higher than 9.84%and 4.92%in the control group(P<0.05).There was no significant difference in the urination time,peak time,average urine flow rate and maximum urine flow rate between the two groups(P>0.05).The indexes of muscle potential,muscle strength and fiber fatigue of Class I and II muscle fibers in the study group were lower than those in the control group(P<0.05).Conclusion Extensive hysterectomy combined with pelvic lymph node dissection may impair pelvic floor function.