腹腔镜下保留自主神经的广泛子宫切除术对Ⅰa、Ⅰb期宫颈癌患者的疗效分析  被引量:13

Analysis of the Curative Effect of Laparoscopic Extensive Hysterectomy with Preservation of Autonomic Nerve in the Treatment of Patients with StageⅠa andⅠb Cervical Cancer

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作  者:樊爱粉 曹士红 FAN Aifen;CAO Shihong(Zhengzhou People's Hospital,Zhengzhou,450000)

机构地区:[1]郑州人民医院,450000

出  处:《实用癌症杂志》2022年第3期481-484,共4页The Practical Journal of Cancer

摘  要:目的分析腹腔镜下保留自主神经的广泛子宫切除术(LNSRH)治疗Ⅰa、Ⅰb期宫颈癌患者的效果。方法抽取97例Ⅰa、Ⅰb期宫颈癌患者,依照手术方案不同分为两组。对照组(48例)接受腹腔镜下广泛性子宫切除术治疗,观察组(49例)接受LNSRH治疗,比较两组治疗效果。结果两组手术时长、阴道切除长度、宫旁切除长度、术中失血量、淋巴结清除数目对比,均无明显差异(P>0.05);与对照组对比,观察组排气、排便时间均较短(P<0.05);术后1个月,两组血清肿瘤标志物水平均降低,但组间血清鳞状细胞癌抗原(SCC-Ag)、糖链抗原724(CA724)水平对比无明显差异(P>0.05);术后1个月,两组尿流动力学指标水平均有所降低,而观察组膀胱顺应性、最大尿流率、最大逼尿肌收缩压均较对照组高(P<0.05);观察组尿潴留、腹压排尿、膀胱功能障碍发生率均低于对照组(P<0.05)。结论LNSRH治疗Ⅰa、Ⅰb期宫颈癌,能有效促进术后恢复,减小对患者尿流动力学水平的影响,降低并发症发生风险,且不会对肿瘤切除效果造成影响。Objective To analyze the effect of laparoscopic autonomic-sparing wide hysterectomy(LNSRH)in the treatment of patients with stageⅠa andⅠb cervical cancer.Methods A total of 97 patients with stageⅠa andⅠb cervical cancer were selected and divided into 2 groups according to different surgical plans.The control group(48 cases)received laparoscopic extensive hysterectomy,and the observation group(49 cases)received LNSRH treatment.The therapeutic effects of the 2 groups were compared.Results There was no significant difference in the length of operation,vaginal resection,parahysterectomy,intraoperative blood loss and number of lymph nodes removed between the 2 groups(P>0.05).Compared with the control group,the observation group had shorter exhaust and defecation time(P<0.05);1 month after operation,the levels of serum tumor markers in the 2 groups were decreased,but there was no significant difference in the levels of serum squamous cell carcinoma antigen(SCC-Ag)and sugar chain antigen 724(CA724)between the 2 groups(P<0.05).P>0.05);1 month after operation,the levels of urodynamic indexes in the 2 groups were decreased,while the bladder compliance,maximum urine flow rate and maximum detrusor systolic blood pressure in the observation group were higher than those in the control group(P<0.05).The incidences of urinary retention,abdominal pressure urination and bladder dysfunction in the observation group were lower than those in the control group(P<0.05).Conclusion LNSRH in the treatment of stageⅠa andⅠb cervical cancer can effectively promote postoperative recovery,reduce the impact on the patient's urodynamic level,and reduce the risk of complications,without affecting the effect of tumor resection.

关 键 词:腹腔镜 保留自主神经 广泛子宫切除术 Ⅰa、Ⅰb期 宫颈癌 尿流动力学 肿瘤标志物 

分 类 号:R737.33[医药卫生—肿瘤]

 

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