早期宫颈癌腹腔镜改良保留盆腔自主神经广泛子宫切除术的临床观察  

Clinical observation of laparoscopy in the modified nerve plane-sparing radical hysterectomy of early cervical cancer

作　　者：江玉娥[1] 丘媚妮[1] 陈海英[1] 梁小花[1] 张映霞[1] 

机构地区：[1]嘉应学院医学院附属医院妇产科,广东梅州514031

出　　处：《赣南医学院学报》2015年第2期255-258,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的:观察早期宫颈癌腹腔镜改良保留盆腔自主神经广泛子宫切除术的安全性、术后恢复情况。方法:将40例早期宫颈癌患者随机分为腹腔镜下改良保留盆腔自主神经广泛子宫切除术治疗的NPSRH组20例,和传统腹腔镜下广泛子宫切除术的LRH组20例,观察两组手术相关指标及术后肠道、膀胱功能恢复时间。结果:两组术中出血量、宫旁和阴道切除范围、术后肠道恢复时间两组比较差异无统计学意义(P>0.05)。NPSRH组和LRH组患者的手术时间分别为(315.6±39.6)min和(242.2±24.7)min,差异有统计学意义(P<0.01),术后住院时间分别为(9.8±3.4)d和(12.6±4.2)d,差异有统计学意义(P<0.05);NPSRH组和LRH组的残余尿量分别为(64.8±8.3)m L、(98.3±7.2)m L,NPSRH组术后拔除尿管的平均时间为(10.2±3.6)d,明显短于LRH组的(16.8±4.1)d,差异均有统计学意义(P<0.01)。结论:NPSRH治疗早期宫颈癌安全、可行,可明显减少术后膀胱功能障碍,有利于患者术后恢复及生活质量提高。Objective： To observe the safety and postoperative recovery of laparoscopy in the modified nerve plane-sparing radical hysterectomy（ NPSRH） of early cervical cancer. Methods： 40 patients with early cervical cancer were enrolled and randomly divided into NPSRH group and LRH group in the study,postoperative short-term intestinal and bladder function of these patients was also analyzed. Results： There was no significant difference between NPSRH group and LRH group in terms of the quantity of mean intraoperative blood loss,extent of parametrium and vagina resection,the recovery time of bowel. The mean operation time in NPSRH group was（ 315. 6 ± 39. 6） min,longer than（ 242. 2 ± 24. 7） min in LRH group（ P〈0. 01）. The duration of postoperative hospital stay in NPSRH group was（ 9. 8 ± 3. 4） d,shorter than（ 12. 6± 4. 2） d in LRH group（ P〈0. 05）. The residual urine volume in NPSRH group was（ 64. 8 ± 8. 3） mL,less than（ 98. 3 ± 7. 2） mL in LRH group（ P〈0. 01）. The mean time of catheter removing in NPSRH group was（ 10. 84 ± 3. 2）d,shorter than（ 17. 4 ± 3. 2） d（ P〈0. 01）. Conclusions： NPSRH is safe and feasible for treating early cervical cancer and can significantly reduce postoperative bladder dysfunction. It can also help patients with postoperative recovery and improve quality of life.

关 键 词：腹腔镜 宫颈癌 改良保留神经根治性子宫切除术 盆腔自主神经平面 膀胱功能 

分 类 号：R737.33[医药卫生—肿瘤]