腹腔镜下低位直肠癌手术中保留盆腔自主神经的临床价值  

Clinical value of pelvic autonomic nerve preservation during laparoscopic surgery for low rectal cancer

作　　者：侯雷[1] 刘志满[1] 张学敏[1] 赵明明[1] 

机构地区：[1]承德医学院附属医院肿瘤外科,河北省承德市067000

出　　处：《世界华人消化杂志》2013年第21期2113-2116,共4页World Chinese Journal of Digestology

摘　　要：目的:观察腹腔镜下低位直肠癌手术中保留盆腔自主神经(pelvic autonomic nerve,PANP)的作用.方法:对76例腹腔镜下中低位直肠癌手术进行回顾性临床研究,其中40例PANP(观察组),36例非PANP(对照组).观察两组近期、远期排尿情况,同时对患者进行了为期3年的临床随访,并在最后一次随访时进行生活质量评分调查.结果:观察组患者近期、远期排尿功能的恢复均好于对照组(17.50%vs47.22%,0%vs5.56%,P<0.05).心理状态[焦虑自评量表(self-rating anxietyscale)、抑郁量表(self-ratingdepression scale)]、自尊评价(self esteem)等相关生活质量评分,观察组亦显著好于对照组(36.64±4.27vs42.37±4.35,32.84±3.21vs39.43±3.92,24.45±4.20vs18.54±3.20,均P<0.01).结论:腹腔镜下中低位直肠癌手术中保留PANP对患者排尿功能影响较小,提高患者的生活质量.AIM： To observe the function of pelvic auto- nomic nerve preservation （PANP） during lapa- roscopic surgery for low rectal cancer. METHODS： Seventy-six elderly patients who underwent laparoscopic surgery for low rectal cancer were included in this study. These pa- tients were divided into either an observation group （n = 40） or a control group （n = 36）. The observation group underwent PANP, while the control group did not undergo PANP. After treatment, the short-term and long-term micturi- tion function was observed. In addition, a three- year follow-up was performed, and the quality of life was scored at the last follow-up. RESULTS： The percentage of patients who had improved short-term and long-term micturition function was significantly higher in the observa- tion group than in the control group （17.50% vs47.22%, 0% vs 5.56%, both P 〈 0.05）. Psychologi- cal state （SAS, SDS） and self esteem （SES） scores were significantly better in the observation group than in the control group （36.64 ±4.27 vs 42.37 ± 4.35, 32.84 ± 3.21 vs 39.43 ± 3.92, 24.45 ± 4.20 vs 18.54 ± 3.20, all P 〈 0.01）.CONCLUSION： PANP during laparoscopic surgery for low rectal cancer can improve mic- turition function and patient＇s quality of life.

关 键 词：腹腔镜 低位直肠癌 盆腔自主神经 

分 类 号：R735.37[医药卫生—肿瘤]