腹腔镜下结肠癌根治术后盆腔自主神经保留的临床研究  

Clinical study of postoperative pelvic autonomic nerve preservation in laparoscopic colon cancer radical operation

作　　者：赵亮[1] 王静[1] 

机构地区：[1]湖北省黄石市中心医院/湖北理工学院附属医院肿瘤外科,435000

出　　处：《检验医学与临床》2015年第14期2021-2022,2025,共3页Laboratory Medicine and Clinic

基　　金：湖北省黄石市医药卫生科研立项项目(2013004)

摘　　要：目的探讨腹腔镜下结肠癌根治术保留盆腔自主神经功能的临床价值,在保证患者术后生存期的前提下,尽量提高患者的生活质量。方法选取2011年4月至2014年8月该院收治的腹腔镜下行结肠癌根治术的男性患者76例,将其分为对照组（37例）和观察组（39例）。对照组患者给予常规手术;观察组患者在常规手术的基础上注意对盆腔自主神经进行分离和保护。对两组患者排尿功能及性功能进行评价。结果术后6个月,对照组患者排尿功能达到Ⅰ~Ⅲ级者分别占51.35%、37.84%和10.81%,观察组Ⅰ级和Ⅱ级者分别占92.31%、7.69%,无Ⅲ级者,观察组患者排尿功能明显优于对照组,两组比较差异有统计学意义（P〈0.05）。对照组患者性功能Ⅰ~Ⅳ级者分别占37.84%、35.14%、13.51%和13.51%,观察组分别53.85%、33.33%、10.26%和2.56%,观察组患者性功能明显优于对照组,两组比较差异有统计学意义（P〈0.05）。结论行腹腔镜下结肠癌根治术,既要保证原发灶彻底切除、充分清扫淋巴结,又要尽可能地保护患者的盆腔内脏神经,兼顾患者的生活质量。Objective To investigate the clinical value of laparoscopic colon radical operation in preserving the pelvic autonomic nerve function for improving the quality of life to the greatest extent under the premise of ensuring the survival period of patients after surgery.Methods 76 patients with laparoscopic colon caner radical operation in our hospital from April 2011 to August 2014 were divided into the control group（37cases）and the observation group（39cases）.The control group was treated with the conventional surgery,while on the basis of the conventional operation the observation group paid attention to the separation and protection of pelvic autonomic nerve.The urinary function and sexual function were evaluated in the two groups.Results The urinary function classⅠ-Ⅲafter postoperative 6months in the control group accounted for 51.35%,37.84% and 10.81% respectively,while the urinary function classⅠ,Ⅱin the observation group were 92.31% and 7.69% without gradeⅢ,indicating that the urination function in the observation group was significantly superior to that in the control group,the difference was statistically significant（P〈0.05）.The sexual functionⅠ-Ⅳclass in the control group accounted for 37.84%,35.14%,13.51% and 13.51% respectively,in which in the observation group aoouncted for 53.85%,33.33%,10.26% and2.56% respectively,the observation group was significantly better than the control group in the sexual function,the difference was statistically significant（P〈0.05）.Conclusion Laparoscopic colon cancer radical operation is necessary to ensure the complete removal of primary tumor and lymph node sufficient excision,but also as far as possible to protect the patient′s pelvic splanchnic nerve and take into account the quality of life of patients.

关 键 词：腹腔镜 肠癌根治术 自主神经 

分 类 号：R735.37[医药卫生—肿瘤]