摘要
目的比较腹腔镜下保留盆腔神经的根治性子宫切除术(NSRH)与传统广泛性全子宫切除术(RH)对术后膀胱、直肠功能恢复的影响及其远期生存状态,以期为宫颈癌的临床治疗提供依据。方法选取2010年1月—2014年6月宫颈癌患者137例,随机分为NSRH组(n=67)和RH组(n=70)进行手术,记录两组患者的术中情况、术后膀胱及直肠功能并进行随访,计算其3年生存率。结果 NSRH组与RH组在手术时间、术中出血量、主韧带切除长度、宫骶韧带切除长度、前壁切除长度、后壁切除长度及盆腔淋巴清扫个数等方面的差异均无显著性意义(P<0.05)。术后膀胱功能方面,NSRH组导尿管拔除时间短于RH组10日后残余尿量少于RH组,两组差异经检验均有显著性意义(P<0.05)。术后直肠功能方面,NSRH组术后排气时间及排便时间均短于RH组,两组差异经检验均有显著性意义(P<0.05)。NSRH组患者的3年总生存率为93.9%,RH组患者的3年总生存率为95.2%,两组生存率差异无显著性意义(P>0.05)。结论 NSRH手术安全可靠,对改善患者并发症尤其是膀胱障碍和直肠功能障碍、提高生存质量、加速术后恢复具有积极作用,但其远期疗效仍需进一步研究。
Objective To investigate the postoperative recovery of bladder and anorectal functions,and future surviving after nerve sparing radical hysterectomy（ NSRH） and radical hysterectomy（ RH）. Methods 137 cervical cancer patients from January 2010 to June 2014 were randomized into 2 groups： NSRH group（ n = 67） and RH group（ n = 70）. Intraoperative conditions and postoperative recovery of bladder and anorectal functions were analyzed. Follow- up was performed 6 ~ 41 months after the operation and three year survival rates were calculated. Results Between NSRH group and RH group,there were no statistical significances in the operation time,blood loss,ligament resection length,the length of vagina to be removed and lymph nodes（ P〉0. 05）. For the postoperative recovery of bladder function,NSRH group had shorter time for extraction of catheter and less residual urine after 10 days than RH group（ P〈0. 05）. For the postoperative recovery of anorectal function,NSRH group had shorter time for exhaust and defecation after operation than RH group（ P〈0. 05）. The three year survival rates were 93. 9% in NSRH group and 95. 2% in RH group,respectively. There was no statistical significance between the groups（ P〉0. 05）. Conclusion NSRH is a safe and practicable approach,and has a positive effect on improving the postoperative recovery of bladder and anorectal functions. But its long- term effect needs more study.
出处
《大连医科大学学报》
CAS
2015年第1期49-52,共4页
Journal of Dalian Medical University
