两种麻醉方案对腹腔镜盆腔植物神经保留术直肠癌患者生殖系统功能影响的对照研究  

Effects of different anesthesia methods on the urinal and sexual function of patients with rectal cancer after laparoscope pelvic autonomic nerve preservation

作　　者：朱雅平[1] 蒋华[2] 戴莺莺[3] 

机构地区：[1]海盐县中医院麻醉科,浙江嘉兴314300 [2]海南省人民医院麻醉科,海口570311 [3]杭州市肿瘤医院妇科,杭州310002

出　　处：《中国性科学》2015年第2期18-20,共3页Chinese Journal of Human Sexuality

基　　金：海南省医药卫生科研项目(1324000320A2020)

摘　　要：目的:探讨不同麻醉方式对盆腔植物神经保留术直肠癌患者生殖系统功能的影响。方法:2010年1月至2013年12月在我院行腹腔镜盆腔植物神经保留术的直肠癌患者68例分为两组各34例,A组采用全凭静脉麻醉;B组采用硬膜外阻滞复合静脉全麻。对比两组的疼痛视觉评分与排尿功能、性功能指标。结果:两组患者均有良好的术后镇痛效果。A组术后2h,24h VAS评分(3.93±0.62,3.63±0.34)高于B组(1.72±0.66,1.89±0.53)(P<0.05)。A组排尿障碍发生率(26.47%)明显高于B组(8.82%)(P<0.05)。A组射精障碍(64.71%)高于B组(29.41%)(P<0.05);A组勃起障碍(58.82%)高于B组(23.53%)(P<0.05)。结论:与静脉麻醉比较,采用硬膜外阻滞复合静脉麻醉,有利于减少盆腔植物神经保留术直肠癌患者术后泌尿及生殖功能障碍发生率,从而提高术后生活质量。Objectives： To investigate the effects of different anesthesia methods on urinal and sexual function in patients with rectal cancer laparoscope pelvic autonomic nerve preservation. Methods： 68 patients with rectal cancer laparoscope pelvic autonomic nerve preservation in our hospital from Jan 2010 to Dec 2013 were divided into two groups. The A group received total intravenous anesthesia while B group received total intravenous anesthesia combined with eqidural anesthesia. Visual analogue scale（ VAS） and urinal and sexual function after operation were compared. Results： The VAS score of 2h,24 h after operation in A group（ 3. 93 ± 0. 62,3. 63 ± 0. 34） were higher than those in B group（ 1. 72 ± 0. 66,1. 89 ± 0. 53）（ P〈0. 05）. The incidence rate of urinal dysfunction in A group（ 26. 47%） was higher than that in B group（ 8. 82%）（ P〈0. 05）. The incidence rate of penile erectile dysfunction in A group（ 64. 71%） was higher than that in B group（ 29. 41%）（ P〈0. 05）. The incidence rate of ejaculatory dysfunction in A group（ 58. 82%） was higher than that in B group（ 23. 53%）（ P〈0. 05）. Conclusion： Total intravenous anesthesia combined with eqidural anesthesia produces less urinal and sexual dysfunction in patients with rectal cancer laparoscope pelvic autonomic nerve preservation than total intravenous anesthesia.

关 键 词：麻醉 腹腔镜 直肠癌 生殖系统功能 

分 类 号：R167[医药卫生—公共卫生与预防医学]