摘要
目的比较腹腔镜下保留盆腔自主神经功能的广泛性子宫切除术(LNSRH)与传统广泛性子宫切除术(LRH)治疗早期宫颈癌的效果及对患者膀胱和直肠功能恢复的影响。方法抽取2018年3月至2021年3月河南省人民医院收治的早期宫颈癌患者80例,依据术式分为LNSRH组和LRH组,每组40例。LNSRH组患者采用LNSRH,LRH组采用LRH。比较两组患者的手术相关指标及生存情况;随访2年,观察两组患者的膀胱、直肠功能恢复情况及生存质量。结果两组患者术中淋巴结清扫个数、阴道前壁及后壁切除长度、主韧带及宫骶韧带切除长度比较差异未见统计学意义(P>0.05)。两组患者2年生存率比较差异未见统计学意义(P>0.05)。随访2年后,LNSRH组最大尿流率、最大逼尿肌收缩压、膀胱顺行性、身体功能及总体评分均高于LRH组,差异有统计学意义(P<0.05);随访2年后,LNSRH组腹泻、便秘发生率及腹泻、便秘评分均低于LRH组,差异有统计学意义(P<0.05)。结论LNSRH和LRH治疗早期宫颈癌均可改善患者预后,且生存率相似,但保留盆腔自主神经功能可有效改善膀胱和直肠功能,提升患者生存质量。
Objective To compare the therapeutic effect of laparoscopic nerve-sparing radical hysterectomy(LNSRH)and laparoscopic radical hysterectomy(LRH)on early cervical cancer,and its influence on the recovery of bladder and rectal function.Methods Eighty patients with early cervical cancer admitted to Henan Provincial People’s Hospital from March 2018 to March 2021 were selected and divided into LNSRH group and LRH group according to surgery procedures,with 40 cases in each group.Patients in the LNSRH group were treated by LNSRH,and patients in the LRH group were treated by LRH.The surgical related indicators and survival status of the two groups were compared.The patients in the two groups were followed up for 2 years,and the bladder function recovery,rectal function recovery,and quality of life of the two groups were observed.Results There was no statistically significant difference in the number of lymph node dissected,length of anterior and posterior vaginal wall excised,and length of main and sacral ligament excised between the two groups(P>0.05).There was no statistically significant difference in the 2-year survival rate between the two groups(P>0.05).After 2 years of follow-up,the maximum urinary flow velocity,maximum detrusor muscle systolic pressure,bladder compliance,physical function and overall score in the LNSRH group were higher than those in the LRH group(P<0.05).After 2 years of follow-up,the incidence and score of diarrhea and constipation in the LNSRH group were lower than those in the LRH group(P<0.05).Conclusions Both LNSRH and LRH can improve the prognosis of early cervical cancer patients and have similar survival rates,however,preserving pelvic autonomic nerve function can effectively improve bladder and rectal function,and improve patients’quality of life.
作者
王精华
冯宪凌
王婷
赵丹
马润红
白杨
Wang Jinghua;Feng Xianling;Wang Ting;Zhao Dan;Ma Runhong;Bai Yang(Department of Gynaecology,Henan Provincial People’s Hospital,People’s Hospital of Zhengzhou University,Henan Provincial Key Laboratory of Nursing,Zhengzhou 450000,China)
出处
《中国实用医刊》
2023年第14期1-4,共4页
Chinese Journal of Practical Medicine
