摘要
目的探讨腹腔镜下广泛子宫切除术中保留盆腔自主神经的手术效果及对患者直肠、膀胱功能的影响。方法选取我院手术治疗的78例,收集时间2013年1月至2017年8月,其中39例患者采用腹腔镜广泛子宫切除术未保留盆腔自主神经(对照组)、另外39例患者采用腹腔镜广泛子宫切除术保留盆腔自主神经(研究组)。结果研究组患者的留置导尿管时间均显著低于对照组,差异有统计学意义(P<0. 05);研究组的手术时间、出血量大于对照组,差异有统计学意义(P<0. 05);研究组和对照组的清扫淋巴结数目、住院时间差异无统计学意义(P>0. 05);研究组患者的膀胱残余尿量、膀胱内压、膀胱相关并发症发生率均低于对照组,差异有统计学意义(P<0. 05);研究组患者的直肠感觉阈值、便秘发生率均低于对照组,差异有统计学意义(P<0. 05),两组患者直肠肛门抑制反射消失发生率差异无统计学意义(P>0. 05)。结论腹腔镜下广泛子宫切除术中保留盆腔自主神经有利于患者术后膀胱及直肠功能恢复,同时具有可靠的手术效果。
Objective To investigate the effect of preserving pelvic autonomic nerve in laparoscopic extensive hysterectomy and its effect on rectum and bladder function. Methods 78 cases of patients received surgical treatment in our hospital were selected and collected from January 2013 to August 2017. Among them,39 patients were treated with laparoscopic extensive hysterectomy without pelvic autonomic nerve preservation( control group),while the other 39 patients received laparoscopic extensive hysterectomy with pelvic autonomic nerve preservation( study group). Results The time of indwelling catheter in study group was significantly lower than that in control group( P<0. 05);The time of operation and the amount of bleeding in the study group were larger than those in the control group,and the difference was statistically significant( P<0. 05);There was no significant difference in the number of lymph nodes dissected and the length of hospitalization between the study group and the control group( P>0. 05);The residual urinary volume,intravesical pressure and the incidence of bladder related complications in the study group were significantly lower than those in the control group( P<0. 05);The rectal sensory threshold and the incidence of constipation in the study group were significantly lower than those in the control group( P<0. 05),no significant difference in the incidence of rectoanal inhibitory reflex disappearance between the two groups( P>0. 05). Conclusion The preservation of pelvic autonomic nerve in extensive hysterectomy under laparoscope is beneficial to the recovery of bladder and rectum function after operation and has a reliable surgical effect.
作者
黎勇明
Li Yongming(Guigang People's Hospital,Guigang,Guangxi 537100,China)
出处
《四川医学》
CAS
2019年第3期288-291,共4页
Sichuan Medical Journal
关键词
腹腔镜
广泛子宫切除术
盆腔自主神经
laparoscopy
extensive hysterectomy
pelvic autonomic nerve
