保留盆腔自主神经功能的子宫广泛切除及盆腔淋巴结切除术对膀胱功能的影响  

Postoperative Bladder Function in Patients' Enduring Pelvic Autonomic Nerves Reserved Uterus Extensive Resection and Pelvic Lymph Node Dissection

作　　者：王倩青[1] 纪妹[2] 

机构地区：[1]河南省新乡市中心医院,河南新乡453000 [2]郑州大学第一附属医院,河南郑州450052

出　　处：《实用妇产科杂志》2014年第12期942-945,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨保留盆腔自主神经功能的子宫广泛切除及盆腔淋巴结切除术对膀胱功能的影响。方法:2012年1月至2014年3月共收治64例早期宫颈癌患者,随机分为两组,传统组(32例)接受传统子宫广泛切除术及盆腔淋巴结切除术治疗,保留组(32例)接受保留盆腔自主神经功能的子宫广泛切除及盆腔淋巴结切除术治疗,比较手术前后两组患者尿动力学数据及膀胱功能。结果:保留组术后共21例患者出现排尿障碍,显著少于传统组的32例(P<0.05);两组患者手术后膀胱最大容量、顺应性、最大尿流率及最大尿流率时逼尿肌压力均显著低于术前(P<0.05),且术后保留组顺应性、最大尿流率及最大尿流率时逼尿肌压力均显著高于传统组(P<0.05);保留组患者发生低顺应性膀胱8例、膀胱逼尿肌受损5例、联合出现2项膀胱功能异常1例,分别少于传统组的17例、13例及17例(P<0.05)。结论:保留盆腔自主神经功能的子宫广泛切除及盆腔淋巴结切除术相对于传统的子宫广泛切除及盆腔淋巴结切除术,在保护患者的排尿及膀胱功能上具有较大优势。Objective：To investigate the influence pelvic autonomic nerve reserved uterus extensive resection and pelvic lymphadenectomy to the postoperative bladder function. Methods：A total of 64 cases of early cervical cancer patients were randomly divided into two groups（ n =32） ,the tradition group and the res- ervation group,the bladder function of patients in two groups were compared pre-and post-surgery. Results： 21 patients in reservation group had voiding dysfunction, significantly less than 32 cases in the traditional group （ P 〈 0.05） ; pre-operative bladder capacity, compliance, maximum flow rate and detrusor pressure during maximum urinary flow rate were significantly lower than that of post operation in two groups（ P 〈0.05） ; compliance,the maximum flow rate and detrusor pressure during maximum urinary flow rate were significantly higher than the tradition group （ P 〈 0. 05） ; in reservation group, there were 8 cases of low compliance bladder,5 cases of impaired detrusor,1 case of 2 combined bladder dysfunction,which were less than traditional group（ 17 cases, 13 cases and 17 cases）respectively（ P 〈 0. 05）. Conclusions：Keeping pelvic autonomic nerve function in uterus extensive resection and pelvic lymph node dissection possess more advantages in preserving pelvic autonomic nerve function, which is worthy of promotion.

关 键 词：盆腔自主神经 子宫广泛切除术 盆腔淋巴结切除 尿动力学 

分 类 号：R737.33[医药卫生—肿瘤]