保留盆腔自主神经根治性宫颈癌手术对患者直肠及性功能的影响分析  

The rectum and sexual function influence of pelvic autonomic nerve preservation on cervical cancer patients

作　　者：邵玉婷[1] 王丽媛[2] 

机构地区：[1]鄂东医疗集团黄石市中心医院(湖北理工学院附属医院)妇产科,湖北黄石435000 [2]鄂东医疗集团黄石市中心医院(湖北理工学院附属医院)心血管内科,湖北黄石435000

出　　处：《临床和实验医学杂志》2017年第11期1073-1076,共4页Journal of Clinical and Experimental Medicine

基　　金：湖北省科学技术厅资助项目(编号:EK2016D130016000275)

摘　　要：目的分析保留盆腔自主神经根治性宫颈癌手术对患者直肠及性功能的影响。方法选取2012年6月至2013年5月收治的86例宫颈癌患者,根据随机数表法分为观察组和对照组,每组各43例。对照组进行腹腔镜下根治性子宫切除术,观察组进行保留盆腔自主神经根治性子宫切除术。比较两组患者手术情况,术后直肠功能、膀胱功能,相关量表评分,并发症情况。结果观察组的术中出血量显著少于对照组[(487.34±32.21)ml比(524.76±35.32)ml](P<0.05)。观察组术后排便时间、排气时间、术后残余尿<50 ml时间及术后残余尿<100 ml时间显著短于对照组[(95.32±6.32)h比(112.43±8.12)h,(63.54±5.43)h比(78.32±7.43)h,(14.43±2.44)h比(18.43±3.51)h,(12.04±1.43)h比(16.43±2.24)h],差异均有统计学意义(P<0.05)。术后1年,观察组患者的女性性功能量表(FSFI)、尿失禁生活质量问卷(I-QOL)评分显著高于对照组[(13.46±2.45)分比(10.35±1.87)分,(88.34±7.54)分比(84.32±7.12)分],生存质量调查表(EORTC OLO-C30)评分显著低于对照组[(51.42±3.25)分比(55.63±4.56)分],差异均有统计学意义(P<0.05)。观察组和对照组的并发症发生率比较无显著性差异[8.82%(3/43)比11.76%(4/43)](χ~2=0.1555,P>0.05)。结论保留盆腔自主神经根治性子宫切除术治疗宫颈癌,能改善患者的直肠功能及性功能,可有效提高患者的生存质量。Objective To study the influence of the rectum and sexual function of pelvic autonomic nerve preservation on cervical cancer patients. Methods 86 cases of patients with cervical cancer were selected from June 2012 to May 2013 , according to the stochastic indicator method they were divided into observation group and control group, 43 cases in each group. The control group was treated with radical laparoscopic hysterectomy, the observation group were given the pelvic autonomic radical hysterectomy. The operation, postoperative rectal function, bladder function, correlation scale and complication were compared between the two groups. Results The intraoperatie blood loss of observation group was significantly less than that of the control group [ （487.34 ± 32. 21） ml vs. （524. 76 ± 35.32） ml] （ P 〈 0. 05 ） . Defecation time, postoperative exhaust time, postoperative residual urine time 〈50 ml and postoperative residual urine 〈 100 ml time of observation group were significantly shor-ter than those of the control group [ （95. 32 ± 6.32） h vs. （112.43 ± 8.12） h,（ 63. 54 ± 5.43 ） h vs. （78. 32 ± 7.43 ） h,（ 14. 43 ± 2 .4 4 ） h vs.（18.43 ± 3.51） h,（12. 04 ± 1.43） h vs. （16. 43 ± 2. 24） h],the differences were statistically significant （ P 〈0. 05 ） . 1 year postoperatively, female sexual scale （FSFI） , urinary incontinence quality of life questionnaire （I QOL） score in observation group were significantly higher than those of the control group [（13.46 ± 2. 45） points vs. （10. 35 ± 1. 87 ）,（ 88. 34 ± 7. 54） points vs. （ 84. 32 ± 7. 12） points],quality of life questionnaire （EORTC OLO - C30） score was significantly lower than that of control group [ （51. 42 ± 3. 25 ） points vs. （55. 63 ±4. 56） points] , the difference had statistical significance （ P 〈0. 0 5） . Complication in observation group and the control group had no significant difference [8.82% （3/43） vs. 11.76% （4/43）] （ χ^2=0. 1555 , P 〉0.

关 键 词：宫颈癌 盆腔自主神经 直肠功能 性功能 

分 类 号：R737.33[医药卫生—肿瘤]