筋膜内与筋膜间保留性神经前列腺癌根治术对患者术后性功能及尿控影响的比较研究  

Effect of intrafascial nerve-sparing radical prostatectomy for prostate cancer on sexual function and urinary control

作　　者：袁海建 郑兵[2] 张伟[2] 黄海鸣[2] 徐卫东 YUAN Haijian;ZHENG Bing;ZHANG Wei;HUANG Haiming;XU Weidong(Department of Urinary Surgery,Hai'an Hospital Affiliated to Nantong University,Hai'an 226600,China;Department of Urinary Surgery,Nantong first People's Hospital,Nantong 226001,China)

机构地区：[1]南通大学附属海安医院泌尿外科,江苏南通226600 [2]南通市第一人民医院泌尿外科,江苏南通226001

出　　处：《中国肿瘤外科杂志》2020年第5期421-424,共4页Chinese Journal of Surgical Oncology

基　　金：南通科技局民生科技面上项目(MS12018088)。

摘　　要：目的探索T1、T2期前列腺癌患者行筋膜内保留性神经前列腺癌根治术对患者术后性功能和尿控恢复的影响。方法回顾性分析2016年10月至2018年12月在南通大学附属海安医院进行保留性神经的前列腺癌根治术的T1、T2期患者的临床资料,根据手术方式的不同分为筋膜内组(38例)与筋膜间组(45例),比较筋膜内组与筋膜间组术后尿控及性功能恢复情况。结果筋膜内组在术后3个月、6个月、12个月,患者尿失禁发生率低于筋膜间组(P<0.05),尿控恢复情况好于筋膜间组,且随着时间推移,两组尿控情况均好转,但筋膜内组更优效,两组比较差异有统计学意义(P<0.05);筋膜内组术后12个月患者勃起功能正常比例高于筋膜间组(P<0.05)。结论T1、T2期前列腺癌患者筋膜内保留性神经前列腺癌根治术后3、6、12个月,尿控恢复好于筋膜间组,尿失禁发生率低于筋膜间组,术后12个月患者性功能恢复也优于筋膜间组。Objective To explore the effect of intrafascial nerve-sparing radical prostatectomy on the sexual function and urinary control in prostate cancer patients with stage T1-T2.Methods Eighty-three prostate cancer patients with stage T1-T2 who underwent nerve-sparing radical prostatectomy in Hai'an Hospital Affiliated to Nantong University were analyzed retrospectively.According to different operative methods,the patients were divided into intrafascial group(n=38)and interfascial group(n=45).The urinary control and recovery of sexual function were compared between the two groups.Results The incidence of urinary incontinence in the intra fascial group was lower than that in the inter fascial group after 3,6 and 12 months of operation(P<0.05).The recovery of urine control in the intra fascial group was better than that in inter fascial group(P<0.05).As time goes by,the recovery of urine control in both of the groups improved significantly(P<0.05).The proportion of erectile function in 12 months after operation was higher than that in the inter fascial group(P<0.05).Conclusions The recovery of urinary control in patients with stage T1and T2 prostate cancer after intrafascial nerve-sparing radical operation is good,where the incidence of urinary incontinence is lower than that in the inter fascial group.The recovery of sexual function in patients with stage T1-T2 prostate cancer after 12 months is better than that in the inter fascial group.

关 键 词：前列腺癌 性功能 尿控 筋膜内 筋膜间 前列腺癌根治术 

分 类 号：R737.25[医药卫生—肿瘤]