保留自主神经功能的子宫广泛切除术治疗宫颈癌对血清肿瘤标志物及性功能的影响  

Effects of extensive hysterectomy with autonomic nerve function preserving on serum tumor markers and sexual function in cervical cancer

作　　者：孙一 郭婷[2] SUN Yi;GUO Ting(Department of Obstetrics and Gynecology,Chang′an Hospital,Xi′an 710061,Shaanxi,China;The Second Department of Obstetrics,Second Affiliated Hospital of Xi′an Medical College,Xi′an 710038,Shaanxi,China)

机构地区：[1]长安医院妇产科,西安710061 [2]西安医学院第二附属医院产二科,西安710038

出　　处：《中国性科学》2023年第2期92-96,共5页Chinese Journal of Human Sexuality

摘　　要：目的 探讨保留自主神经功能的子宫广泛切除术治疗早期宫颈癌对血清肿瘤标志物及性功能的影响。方法 选取2015年10月至2020年10月在西安医学院第二附属医院实施手术治疗的80例宫颈癌患者作为研究对象,其中44例行保留盆腔植物神经广泛性子宫切除术(NSRH)作为NSRH组,36例行传统子宫广泛性切除术(RH)作为RH组。记录患者手术情况;采用酶联免疫吸附法(ELISA)检测血清糖类抗原125(CA125)、癌胚抗原(CEA)、鳞状上皮细胞癌抗原(SCCA)和癌胚抗原相关细胞黏附分子6(CEACAM6)水平;采用女性性功能量表(FsFx)评估患者性功能;记录患者术后并发症发生率和肿瘤复发率。结果 两组患者手术时间、术中出血量、切除淋巴结数、输血量、宫颈旁和阴道切除长度等比较,差异无统计学意义(P>0.05)。术后3d、7d、10d、14d,两组患者血清CA125、CEA、SCCA和CEACAM6水平均较术前明显持续降低(P<0.05);但两组之间比较,差异无统计学意义(P>0.05)。术后1年,两组患者性功能水平均降低,但NSRH组患者各项性功能评分均明显高于RH组(P<0.05)。NSRH组并发症发生率为11.36%,低于RH组的22.22%(P<0.05);术后5年两组复发率差异无统计学意义(P>0.05)。结论 NSRH术能清扫早期宫颈癌患者的恶性肿瘤环境,同时尽可能维持患者性功能,术后复发率低、并发症少。Objective To explore the effects of extensive hysterectomy with autonomic nerve function preserving on serum tumor markers and sexual function in early cervical cancer. Methods A total of 80 patients with cervical cancer undergoing surgical treatment in Second Affiliated Hospital of Xi′an Medical College between October 2015 and October 2020 were enrolled as the research objects, including 44 patients undergoing nerve-sparing radical hysterectomy(NSRH) in NSRH group and 36 cases undergoing traditional radical hysterectomy(RH) in RH group. The surgical conditions were recorded. Enzyme-linked immunosorbent assay(ELISA) was used to detect the levels of serum carbohydrate antigen 125(CA125), carcinoembryonics antigen(CEA), squamous cell carcinoma antigen(SCCA) and carcinoembryonic antigen associated cell adhesion molecule 6(CEACAM6). Female Sexual Function Scale(FsFx) was used to evaluate the sexual function of patients. The incidence of postoperative complications and recurrence rate of tumors were recorded. Results There was no significant difference in operation time, intraoperative blood loss, excision number of lymph nodes, transfusion volume or length of paracervical and vaginal resection between the two groups(P>0.05). At 3d, 7d, 10d and 14d after surgery, levels of serum CA125, CEA, SCCA and CEACAM6 were significantly and continuously decreased compared with those before surgery in both groups(P<0.05), but there was no significant difference in these indexes between the two group(P>0.05). At 1 year after surgery, sexual function in both groups was declined. The scores of sexual function in NSRH group were significantly higher than those in RH group(P<0.05). and incidence of complications was lower than that in RH group(11.36% vs. 22.22%, P<0.05). The complication rate of NSRH group was 11.36 %, lower than that of RH group(22.22 %)(P<0.05). There was no significant difference in recurrence rate between the two groups at 5 years after surgery(P>0.05). Conclusions NSRH can eliminate malignant tumor environment

关 键 词：保留自主神经功能的子宫广泛切除术 宫颈癌 性功能 肿瘤标志物 

分 类 号：R711[医药卫生—妇产科学]