保留盆腔神经宫颈癌根治术与传统宫颈癌根治术的比较研究

中国临床药理学与治疗学 ›› 2013, Vol. 18 ›› Issue (10): 1148-1154.

保留盆腔神经宫颈癌根治术与传统宫颈癌根治术的比较研究

唐修武, 孙云, 倪观太

皖南医学院第一附属医院妇产科,芜湖 241001,安徽

收稿日期:2013-05-31 修回日期:2013-09-10 出版日期:2013-10-26 发布日期:2013-09-30
通讯作者: 倪观太,男,硕士研究生导师,研究方向:盆底重建及微创。Tel: 0553-5739570 E-mail: t534498173@qq.com
作者简介:唐修武,男,硕士研究生,研究方向:盆底重建及微创。Tel: 0515-89218902 E-mail: tangxiuwu1982@163.com

Comparative study on nerve sparing radical hysterectomy with radical hysterectomy

TANG Xiu-wu, SUN Yun, NI Guan-tai

Department of Gynaecology and Obstetrics,the First Affiliated Hospital of Wannan Medical College, Wuhu 241001,Anhui,China

Received:2013-05-31 Revised:2013-09-10 Online:2013-10-26 Published:2013-09-30

摘要/Abstract

摘要： 目的:探讨保留盆腔自主神经的宫颈癌根治术与传统宫颈癌根治术对患者术后生活质量的影响及其手术效果的初步评估。方法:选择皖南医学院第一附属医院2011年1月至2012年09月收治的经国际妇产科学联盟(FIGO)分期为ⅠB~ⅡA的子宫颈癌患者50例,设研究组(n=20)采用保留盆腔自主神经的宫颈癌根治术,对照组(n=30)行传统的宫颈癌根治术,比较两组手术范围、手术时间、术中出血量、导尿管保留天数、残余尿量、肛门排气、排便时间及术后半年性功能恢复情况。结果:对照组与研究组比较,术后第10天残余尿量分别为(201.83±83.00)、 (139.75±69.01) mL,保留尿管天数(15.20±2.43)、(11.85±2.08) d;术后肛门排气时间分别为(72.97±16.31)、(59.60±13.37) h,术后肛门排便时间分别为(121.17±23.07)、(91.05±11.66)h,两组相比差异具有统计学意义(P＜0.05);术后半年性功能随访结果显示:对照组性功能障碍的发生率为 86.7%,研究组性功能障碍发生率为45%,两组相比差异有统计学意义(P＜0.05),对术后半年未恢复性生活的患者进行原因调查,发现因“害怕疾病复发”占 77.8%;害怕“性交痛或出血”占 55.6%。研究组与对照组手术时间中位数分别为250(180~330) min 和200(150~270) min,术中手术时间、出血量、术中切除主骶韧带、阴道长度及淋巴结清扫数目等指标差异均无统计学意义。结论:保留盆腔自主神经的宫颈癌根治术治疗早期宫颈癌是安全可行的,与传统根治术相比更有利于膀胱、直肠功能的恢复,有助于提高患者术后的生活质量。

关键词: 保留盆腔神经, 宫颈癌根治术, 生活质量, 性功能

Abstract: AIM: To compare the life quality of patients after nerve sparing radical hysterectomy or traditional radical hysterectomy and evaluate the safety of two operations.METHODS: Fifty patients with cervical cancer ofⅠB-ⅡA(FIGO) were selected under the guideline of ethic committee.Thirty of them received traditional radical hysterectomy(RH)as control group and twenty received nerve sparing radical hysterectomy (NSRH)as experimental group.The excision extent, operation time, blood loss, urethral catheter remaining days, residual urine volume, the first exhaust time, defecation time and sexual function recovery were followed up for half a year and these data were compared between the two groups.RESULTS: On the tenth day after operation, the residual urine volume of control group and experimental group were (201.83±83.00) mL and (139.75±69.01)mL; the urethral catheter remaining days of control group was (15.20±2.43) d and the experimental group was (11.85±2.08) d; the first exhaust time was (72.97±16.31) h and(59.60±13.37)h;the first defecation time was (121.17±23.07) h and (91.05±11.66) h,there were statistically difference in two groups(P<0.05). The sexual dysfunction in control group and experimental group control group were 86.7%and 45%,respectively. For six months after operation there were statistically difference between two groups(P<0.05). 77.8% of patients who didn't resume intercourse were afraid of relapse and 55.6% of them were afraid of pain.The median operation time of the two groups were 250 (180-330) min and 205 (150-270) min,and there was no statistically difference between two groups in operation time, blood loss and excision extent.CONCLUSION: NSRH for the patients with cervical cancer is feasible and safe and it can improve the recovery of bladder and rectum functions, and eventually make contribution to quality life of patients.

Key words: Nerve pelvic sparing, Radical hysterectomy, Quality life, Sexual function

中图分类号:

R713

唐修武, 孙云, 倪观太. 保留盆腔神经宫颈癌根治术与传统宫颈癌根治术的比较研究[J]. 中国临床药理学与治疗学, 2013, 18(10): 1148-1154.

TANG Xiu-wu, SUN Yun, NI Guan-tai. Comparative study on nerve sparing radical hysterectomy with radical hysterectomy[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2013, 18(10): 1148-1154.

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