腹腔镜保留神经平面广泛子宫切除术治疗宫颈癌的效果(1)
摘要：目的 探討腹腔镜保留神经平面广泛子宫切除术治疗宫颈癌的临床效果。方法 选择2017年11月～2019年11月我院收治的宫颈癌患者130例，随机分为对照组和研究组，各65例。对照组采用腹腔镜非保留神经平面广泛子宫切除术治疗，研究组给予腹腔镜保留神经平面广泛子宫切除术治疗;比较两组手术指标(手术时间、淋巴结清扫数量、住院时间、宫旁组织切除长度、术中出血量及阴道切除长度)、术后恢复情况(自主排便时间、肛门排气时间、残余尿量、留置尿管时间、膀胱功能障碍及排尿满意度)、尿动力学参数(最大逼尿肌收缩压、最大膀胱容量及膀胱顺应性)及术后并发症发生情况。结果 两组手术时间、淋巴结清扫数量、住院时间、宫旁组织切除长度、术中出血量及阴道切除长度比较，差异无统计学意义(P>0.05);研究组自主排便时间、肛门排气时间、残余尿量、留置尿管时间及膀胱功能障碍低于对照组，排尿满意度高于对照组，差异有统计学意义(P<0.05);研究组最大逼尿肌收缩压、膀胱顺应性高于对照组，最大膀胱容量低于对照组，差异有统计学意义(P<0.05);研究组术后并发症发生率低于对照组，差异有统计学意义(P<0.05)。结论 腹腔镜保留神经平面广泛子宫切除术治疗宫颈癌效果确切，可保留膀胱与直肠功能，改善患者尿动力学参数，安全性高。
关键词：腹腔镜;保留神经平面广泛子宫切除术;宫颈癌
中图分类号：R737.33 文献标识码：A DOI：10.3969/j.issn.1006-1959.2020.20.029
文章编号：1006-1959(2020)20-0099-03
Laparoscopic Nerve Plane Extensive Hysterectomy for Treatment of Cervical Cancer
ZENG Yu-fei，ZHENG Zhi-ping
(Department of Obstetrics and Gynecology，the Fifth People's Hospital of Shangrao City，Shangrao 343000，Jiangxi，China)
Abstract：Objective To investigate the clinical effect of laparoscopic extensive hysterectomy with preserving nerve plane in the treatment of cervical cancer.Methods A total of 130 cervical cancer patients admitted to our hospital from November 2017 to November 2019 were selected and randomly divided into a control group and a study group， with 65 cases in each group. The control group was treated with laparoscopic non-nerve-sparing extensive hysterectomy， and the study group was treated with laparoscopic nerve-saving extensive hysterectomy; the two groups' surgical indicators (operating time， number of lymph node dissections， hospital stay， length of parauterine tissue resection were compared，intraoperative blood loss and length of vaginal resection)， postoperative recovery (time of spontaneous defecation， anal exhaust time， residual urine volume， indwelling catheter time， bladder dysfunction and urination satisfaction)， urodynamic parameters (maximum force Urinary muscle systolic pressure， maximum bladder capacity and bladder compliance) and postoperative complications.Results There were no statistically significant differences in the operation time， number of lymph node dissections， hospital stay， length of parauterine tissue resection， intraoperative blood loss， and length of vaginal resection between the two groups (P>0.05); The study group's spontaneous defecation time， anal exhaust time， residual urine volume， indwelling catheter time and bladder dysfunction were lower than those of the control group， and urination satisfaction was higher than that of the control group， the difference was statistically significant (P<0.05); the study group was the largest the detrusor systolic pressure and bladder compliance were higher than the control group， and the maximum bladder capacity was lower than the control group， the difference was statistically significant (P<0.05); the postoperative complication rate in the study group was lower than the control group， the difference was statistically significant (P<0.05).Conclusion Laparoscopic extensive hysterectomy with preserving nerve plane was effective in the treatment of cervical cancer. It could preserve bladder and rectal function， improve patient urodynamic parameters， and had high safety., 百拇医药(曾育飞 郑智娉)
关键词：腹腔镜;保留神经平面广泛子宫切除术;宫颈癌
中图分类号：R737.33 文献标识码：A DOI：10.3969/j.issn.1006-1959.2020.20.029
文章编号：1006-1959(2020)20-0099-03
Laparoscopic Nerve Plane Extensive Hysterectomy for Treatment of Cervical Cancer
ZENG Yu-fei，ZHENG Zhi-ping
(Department of Obstetrics and Gynecology，the Fifth People's Hospital of Shangrao City，Shangrao 343000，Jiangxi，China)
Abstract：Objective To investigate the clinical effect of laparoscopic extensive hysterectomy with preserving nerve plane in the treatment of cervical cancer.Methods A total of 130 cervical cancer patients admitted to our hospital from November 2017 to November 2019 were selected and randomly divided into a control group and a study group， with 65 cases in each group. The control group was treated with laparoscopic non-nerve-sparing extensive hysterectomy， and the study group was treated with laparoscopic nerve-saving extensive hysterectomy; the two groups' surgical indicators (operating time， number of lymph node dissections， hospital stay， length of parauterine tissue resection were compared，intraoperative blood loss and length of vaginal resection)， postoperative recovery (time of spontaneous defecation， anal exhaust time， residual urine volume， indwelling catheter time， bladder dysfunction and urination satisfaction)， urodynamic parameters (maximum force Urinary muscle systolic pressure， maximum bladder capacity and bladder compliance) and postoperative complications.Results There were no statistically significant differences in the operation time， number of lymph node dissections， hospital stay， length of parauterine tissue resection， intraoperative blood loss， and length of vaginal resection between the two groups (P>0.05); The study group's spontaneous defecation time， anal exhaust time， residual urine volume， indwelling catheter time and bladder dysfunction were lower than those of the control group， and urination satisfaction was higher than that of the control group， the difference was statistically significant (P<0.05); the study group was the largest the detrusor systolic pressure and bladder compliance were higher than the control group， and the maximum bladder capacity was lower than the control group， the difference was statistically significant (P<0.05); the postoperative complication rate in the study group was lower than the control group， the difference was statistically significant (P<0.05).Conclusion Laparoscopic extensive hysterectomy with preserving nerve plane was effective in the treatment of cervical cancer. It could preserve bladder and rectal function， improve patient urodynamic parameters， and had high safety., 百拇医药(曾育飞 郑智娉)