摘要
目的比较腹腔镜宫颈癌根治术与开腹宫颈癌根治术治疗早期宫颈癌的临床疗效和对性生活质量的影响。方法选取安徽医科大学附属安庆医院近4年来实施广泛性全子宫切除加盆腔淋巴结清扫术的宫颈癌患者40例,其中腹腔镜宫颈癌根治术(腹腔镜组)20例、开腹宫颈癌根治术(开腹组)20例。观察比较两组的住院时间、手术时间、术中出血量、术后排气时间和术后并发症的情况,并于术后4个月、8个月、1年采用欧洲癌症研究和治疗组织(EORTC)针对宫颈癌患者建立的QLQCX 24评价量表随访调查患者的术后性生活质量。结果腹腔镜手术与开腹手术相比,患者住院时间短[(13.40±1.88)比(16.05±2.82)d]、术中出血量少(100 m L比600 m L)、排气时间早[(56.90±6.37)比(63.90±10.83)h]、术后并发症少(P<0.05),两组手术时间[(228.05±55.49)比(245.70±82.49)min]差异无统计学意义(P>0.05)。术后3次随访,两组患者术后第4个月的随访性功能及阴道功能均降低,而腹腔镜组相对于开腹手术,性生活相关困扰少,性活跃度和愉悦感方面高,差异有统计学意义(P<0.05)。而术后8个月及1年腹腔镜组与开腹组相比,各个维度均差异无统计学意义(P>0.05)。结论腹腔镜手术与开腹手术治疗早期宫颈癌相比,术后并发症少,病人恢复快,而在性生活质量方面,术后4个月内腹腔镜组高于开腹组,术后4个月后两组无差异无统计学意义,总体来说,两组宫颈癌患者术后1年内性生活质量与术前相比仍下降。
Objective To compare the clinical effects and sexual function between laparoscopic surgery and laparotomy for early cervical cancer. Methods 40 patients with early cervical cancer were divided into the laparoscopic surgery group（20） and the laparotomy group（20）. The length of hospital stays,surgical time,blood loss,postoperative exhaust time were observed. The scale scores assessed by the QLQ-CX 24 were calculated at four months,eight months and one year follow-up period. Results There were no significant differences in surgical time between the two groups [（228. 05 ± 55. 49） vs.（245. 70 ± 82. 49） min],but hospital stays [（13. 40± 1. 88） vs.（16. 05 ± 2. 82） d],blood loss（100 mL vs. 600 mL）,postoperative exhaust time [（56. 90 ± 6. 37） vs.（63. 90 ±10. 83） h] were statistically different（P〈0. 05）. As for the sexual function scales at four months follow-up,the vaginal or sexual function were both decreased,but the laparoscopic surgery group had less sexual worry and more sexual enjoyment compared to the laparotomy group. However,there was no significant difference in eight months and one year follow-up. Conclusions Laparoscopic surgery has higher clinical effects,but,there was no significant impact on quality of sexual life between these two groups.
作者
王悦
王根生
国萍
朱慧芬
WANG Yue;WANG Gensheng;GUO Ping;ZHU Huifen(Department of Gynecology and Obstetrics,Anqing Hospital Affiliated to Anhui Medical University,Anqing,Anhui 246000,China)
出处
《安徽医药》
CAS
2018年第8期1463-1466,共4页
Anhui Medical and Pharmaceutical Journal
基金
安徽医科大学校科研基金(2015xkj154)
