宫颈癌保留神经手术后排尿功能评价

Postsurgical urodynamic study of nerve-sparing radical hysterectomy in the treatment of cervical cancer

目的探讨宫颈癌保留神经的广泛性子宫切除术(nerve sparing radical hysterectomy,NSRH)治疗宫颈癌的效果及对排尿功能的影响。方法纳入2019年5月至2022年5月于首都医科大学附属北京妇产医院就诊并诊断为宫颈癌的患者55例,国际妇产科联盟分期分布在ⅠB至ⅡA2。其中28例患者接受了NSRH(NSRH组),27例患者接受了广泛性全子宫切除术(radical hysterectomy,RH)(RH组)。比较2组患者手术相关指标及术后排尿功能。结果NSRH组平均年龄为(51.0±7.9)岁,RH组平均年龄为(46.3±8.5)岁,年龄分布差异有统计学意义(P<0.05)。2组出血量差异无统计学意义(P>0.05)。2组患者手术切缘均为阴性。术后病理提示阴道长度、淋巴结转移、间质浸润深度、淋巴脉管浸润比较差异均无统计学意义(P>0.05)。在术后膀胱功能方面,NSRH组残余尿较RH组多(P<0.05),但NSRH组拔尿管的时间较RH组明显缩短(P<0.05)。结论NSRH能够在确保手术范围的同时,减轻对术后排尿功能的影响,缩短术后恢复时间。

Objective To compare bladder function between nerve-sparing radical hysterectomy(NSRH)and radical hysterectomy(RH)for patients with uterine cervical cancer.Methods This prospective study enrolled 55 patients with cervical cancer between May 2019 and May 2022 at the Department of Gynecological Oncology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University:with 28 in the NSRH group and 27 in the AH group.Information of patients with stagesⅠB toⅡA cervical cancer were collected according to the inclusion criteria.Demographic,surgical,and oncological data were collected.Results The average age in the NSRH group was(51.0±7.9)years,and(46.3±8.5)years in the RH group,with significant statistical difference(P<0.05).There was no significant difference between the two groups in operation duration,blood loss,vaginal length,lymph node metastasis(P>0.05),depth of stromal invasion,or lymphovascular invasion in the postoperative pathology(P>0.05).Residual urine in NSRH group was more than that in RH group(P<0.05).However,the time to postoperative catheter removal was significantly shorter in NSRH group(P<0.05).Conclusions NSRH can effectively promote the postoperative bladder function of patients with cervical cancer,thereby shortening the recovery time after surgery.