摘要
目的比较腹腔镜与开腹下保留盆腔自主神经(PANP)全直肠系膜切除术(TME)治疗直肠癌的临床效果。方法选取2016年11月~2018年12月江西省九江市第一人民医院收治的76例直肠癌患者作为研究对象,按随机数字表法将其分为观察组与对照组,每组各38例。观察组患者接受腹腔镜下PANP的TME治疗,对照组患者接受开腹下PANP的TME治疗。比较两组患者的围术期指标、排尿功能、性功能障碍发生率及预后情况。结果观察组患者的术中出血量[(103.57±22.06)mL]、残尿量[(15.23±4.97)mL]均低于对照组[(178.79±32.64)、(22.51±6.14)mL],差异有统计学意义(P<0.05)。观察组患者的手术时间[(175.34±42.18)min]长于对照组[(138.52±36.27)min],差异有统计学意义(P<0.05)。观察组患者的排气时间[(2.64±1.20)d]、住院时间[(6.17±1.25)d]、尿管拔除时间[(2.54±1.38)d]均短于对照组[(3.59±1.42)、(11.21±2.03)、(3.36±1.42)d],差异有统计学意义(P<0.05)。观察组患者的自由尿流率[(26.97±5.28)mL/s]高于对照组[(20.63±6.24)mL/s],差异有统计学意义(P<0.05)。观察组患者的射精障碍发生率(10.53%)、勃起功能障碍发生率(5.79%)均低于对照组(34.21%、36.84%),差异有统计学意义(P<0.05)。两组患者的淋巴结清扫数、排尿障碍发生率、复发率、转移率比较,差异无统计学意义(P>0.05)。结论直肠癌患者接受腹腔镜下PANP的TME治疗损伤小且根治效果确切,可缩短住院时间,改善排尿功能及性功能。
Objective To compare the clinical effect of laparoscopic and laparotomic total mesorectal excision(TME)with pelvic autonomic nerve-preserving(PANP)in the treatment of rectal cancer.Methods A total of seventy-six patients with rectal cancer who were treated in the First People′s Hospital of Jiujiang City,Jiangxi Province from November 2016 to December 2018 were selected as the research objects and divided into the observation group and the control group according to the random number table method,with 38 cases in each group.Patients in the observation group received TME treatment with PANP under laparoscope,and patients in the control group received TME treatment with PANP under open surgery.The perioperative indicators,voiding function,the total incidence of sexual dysfunction and prognosis condition were compared between the two groups.Results The intraoperative blood loss([103.57±22.06]mL)and the residual urine volume([15.23±4.97]mL)of the observation group were lower than those of the control group([178.79±32.64],[22.51±6.14]mL),and the differences were statistically significant(P<0.05).The operation time of the observation group([175.34±42.18]min)was longer than that of the control group([138.52±36.27]min),and the difference was statistically significant(P<0.05).The time of exhaust([2.64±1.20]d),hospital stay([6.17±1.25]d),and time of catheter removal([2.54±1.38]d)in the observation group were shorter than those in the control group([3.59±1.42],[11.21±2.03],[3.36±1.42]d),and the differences were statistically significant(P<0.05).The free urine flow rate([26.97±5.28]mL/s)of the observation group was higher than that of the control group([20.63±6.24]mL/s),and the difference was statistically significant(P<0.05).The incidence of ejaculation disorder and erectile dysfunction in the observation group(10.53%,5.79%)were lower than those in the control group(34.21%,36.84%),and the differences were statistically significant(P<0.05).There were no statistically significant differences in amount of lymph
作者
夏绿池
万炎华
汪传文
XIA Lv-chi;WAN Yan-hua;WANG Chuan-wen(Department of Emergency,the First People′s Hospital of Jiujiang City,Jiangxi Province,Jiujiang332000,China;Department of General Surgery,the First People′s Hospital of Jiujiang City,Jiangxi Province,Jiujiang332000,China)
出处
《中国当代医药》
2020年第33期90-93,共4页
China Modern Medicine
基金
江西省卫生计生委科技计划项目(20177087)。
关键词
直肠癌
腹腔镜
全直肠系膜切除术
保留盆腔自主神经
排尿功能
Rectal cancer
Laparoscopy
Total mesorectal resection
Pelvic autonomic nerve-preserving
Voiding function
