腹腔镜下保留盆腔自主神经对子宫切除术患者的盆腔脏器保护作用

Protective effect of preservation of pelvic autonomic nerves in laparoscopic radical hysterectomy on pelvic organs of patients

目的研究腹腔镜下保留盆腔自主神经对子宫切除术患者的盆腔脏器保护作用。方法选取我院妇产科2014年3月至2015年3月收治的宫颈癌行子宫切除术患者98例为研究对象,按随机表法分为观察组与对照组,每组49例,观察组接受腹腔镜下保留盆腔自主神经子宫切除术,对照组接受腹腔镜下不保留盆腔自主神经子宫切除术。比较两组手术方式盆腔脏器保护作用。结果与对照组比较,观察组术后排气时间[(36.71±5.37)h vs(62.15±9.13)h]、术后排便时间[(74.29±9.15)h vs(108.18±11.83)h]、留置尿管时间[(7.25±1.72)d vs(16.09±3.47)d]、总住院时间[(5.16±0.57)d vs(7.84±1.02)d]均明显低于对照组且差异均具有统计学意义(P<0.05),但观察组手术时间较对照组长且差异具有统计学意义[(326.34±17.25)min vs(274.25±22.16)min,P<0.05];观察组的血便、腹泻、便秘发生率明显低于对照组且差异均具有统计学意义(2.04%vs 12.24%、4.08%vs 18.37%、6.12%vs 24.49%,P<0.05);观察组的感觉丧失、尿失禁、储尿排尿功能失调发生率也明显低于对照组且差异均具有统计学意义(2.04%vs 16.33%、4.08%vs 20.41%、8.16%vs 24.49%,P<0.05)。结论腹腔镜下保留盆腔自主神经子宫切除术有助于患者术后更好的恢复,更有利于保护盆腔脏器及其功能。

Objective To study the protective effect of preserving pelvic autonomic nerves in laparoscopic radical hysterectomy on pelvic organs of patients. Methods Ninety-eight patients with cervical carcinoma undergoing cervical hysterectomy in the Department of Gynaecology and Obstetrics in our hospital from March 2014 to March 2015 were randomly assigned into observation group(n=49) and control group(n=49), which received laparoscopic radical hysterectomy with preservation of pelvic autonomic nerves and laparoscopic radical hysterectomy without preservation of pelvic autonomic nerves. Protective effects on pelvic organs were compared between the two groups. Results Compared with the control group, the postoperative discharge time [(36.71 ± 5.37) h vs(62.15 ± 9.13) h], defecation time[(74.29±9.15) h vs(108.18±11.83) h], indwelling catheter time [(7.25±1.72) d vs(16.09±3.47) d] and length of hospital stay [(5.16±0.57) d vs(7.84±1.02) d] in the observation group were significantly shorter(P<0.05), but the operation time was significantly longer [(326.34±17.25) min vs(274.25±22.16) min, P<0.05]. The incidences of bloody stools, diarrhea,and constipation in the observation group were significantly lower than those in the control group(2.04% vs 12.24%,4.08% vs 18.37%, 6.12% vs 24.49%, P<0.05), and the incidences of sensory loss, incontinence, voiding urine storage dysfunction were also significantly lower(2.04% vs 16.33%, 4.08% vs 20.41%, 8.16% vs 24.49%, P<0.05). Conclusion Laparoscopic radical hysterectomy with preservation of pelvic autonomic nerves results in better recovery and is conducive to the protection of the pelvic organs and their functions.