腹腔镜辅助阴式全子宫切除术对宫颈原位癌患者围术期指标及长期盆底功能的影响  

Effect of Laparoscopic-assisted Vaginal Hysterectomy on Perioperative Parameters and Long-term Pelvic Floor Function in Patients with Cervical Carcinoma in situ

作　　者：李玥[1] 叶柳 LI Yue;YE Liu(Shanghai Ninth People's Hospital,Shanghai JiaoTong University Schoolof Medicine,ShangHai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院妇产科

出　　处：《河北医学》2019年第7期1194-1198,共5页Hebei Medicine

基　　金：上海市自然科学基金项目,(编号:14ZR1434259)

摘　　要：目的:探讨腹腔镜辅助阴式全子宫切除术对宫颈原位癌患者围术期相关指标及长期盆底功能的影响。方法:将本院于2014年6月至2017年6月收治的120例宫颈原位癌患者纳入本研究,随机分为实验组(60例)和对照组(60例),对照组进行腹式全子宫切除术,实验组进行腹腔镜辅助阴式全子宫切除术,术后随访12个月,观察两组患者的围术期相关指标及盆底功能。结果:与对照组相比,实验组患者的手术时间(t=2.579,P=0.011)、术后排气时间(t=1.994,P=0.048)、使用抗生素时间(t=5.234,P<0.001)、下床活动时间(t=8.678,P<0.001)、住院时间(t=9.610,P<0.001)明显较短,术中出血量(t=11.343,P<0.001)明显较少,差异均具有统计学意义;另外,实验组术后并发症的发生率为1.67%(1/60),明显低于对照组的16.67%(10/60),差异具有统计学意义(χ^2=8.107,P=0.004);术后疼痛程度明显轻于对照组,差异有显著性(P<0.05)。与术前相比,两组术后性生活质量不满意及压力性尿失禁者均较多(P<0.05)。两组术后6个月、12个月的盆底功能比较均无统计学差异。结论:腔镜辅助下阴式子宫全切除术治疗宫颈原位癌具有术中出血量低、术后并发症少、恢复快、疼痛轻等优点,但可影响术后盆底功能。Objective:To investigate the effect of laparoscopic assisted vaginal hysterectomy on perioperative indexes and long term pelvic floor function in patients with carcinoma in situ of cervix.Methods:120 patients with carcinoma in situ of cervix,treated in our hospital from June 2014 to June 2017,were randomly divided into experimental group(n=60)and control group(n=60).60 patients of the control group were treated with abdominal panhysterectomy,and 60 patients of the experimental group were treated with laparoscopic-assisted vaginal hysterectomy;all patients were followed up for 12 months.The perioperative indexes and pelvic floor function of the two groups were observed.Result:Compared with the control group,the operation time(t=2.579,P=0.011),postoperative exhaust time(t=1.994,P=0.048),anti-infective therapy time(t=5.234,P<0.001),ambulation time(t=8.678,P<0.001),hospitalization time(t=9.610,P<0.001)of the patients in the experimental group were significantly shorter,and intraoperative blood loss(t=11.343,P<0.001)was significantly lower,the differences were statistically significant.In addition,the incidence of postoperative complications in the experimental group was 1.67%(1/60),significantly lower than 16.67%(10/60)of the control group,the difference was statistically significant(χ^2=8.107,P=0.004).The degree of pain in the experimental group was significantly lower than that in the control group,the difference was significant(P<0.05).The patients with poor quality of life and stress urinary incontinence were more than preoperative in two groups(P<0.05).There was no significant difference between the two groups in the pelvic floor function after the operation for 6 months and 12 months.Conclusion:Laparoscopic assisted vaginal hysterectomy for the treatment of carcinoma in situ of cervix with low intraoperative blood loss,fast recovery,less postoperative complications and less pain;but it could affect the pelvic floor function after operation.

关 键 词：阴式子宫全切除术 腹腔镜 宫颈原位癌 术后并发症 盆底功能 

分 类 号：R737.33[医药卫生—肿瘤]