保留与不保留盆腔自主神经的广泛性子宫切除术对Ⅰ期宫颈癌患者肠道、膀胱功能的影响  

Effects of radical hysterectomy with and without pelvic autonomic nerve preservation on intestinal and bladder function in patients with stage I cervical cancer

作　　者：吴春茹 贺全勤 陈亚玲 刘秀玲 李金锋 张化莲 WU Chunru;HE Quanqin;CHEN Yaing;LIU Xiuing;LI Jinfeng;ZHANG Huaian(Department of Obstetrics and Gynecology,Zhumadian Central Hospital,Zhumadian 463000,He'nan,China)

机构地区：[1]驻马店市中心医院妇产科,河南驻马店463000

出　　处：《癌症进展》2024年第21期2348-2351,共4页Oncology Progress

摘　　要：目的 探讨保留与不保留盆腔自主神经的广泛性子宫切除术(RH)对Ⅰ期宫颈癌患者肠道、膀胱功能的影响。方法 根据术中是否保留盆腔自主神经将105例行腹腔镜下RH的Ⅰ期宫颈癌患者分为保留组(n=53)和未保留组(n=52),未保留组患者术中不保留盆腔自主神经,保留组患者术中保留盆腔自主神经。比较两组患者的手术相关指标、肠道功能、膀胱功能[最大尿流率(MFR)、最大逼尿肌压力(MDP)、残余尿量]及术后并发症发生情况。结果 未保留组患者的手术时间短于保留组,术后首次排气时间、术后首次排便时间均长于保留组,肠道功能障碍总发生率、术后并发症总发生率均高于保留组,差异均有统计学意义(P﹤0.05)。术后1个月,两组患者残余尿量均多于本组术前,MFR、MDP均低于本组术前,未保留组患者残余尿量多于保留组,MFR、MDP均低于保留组,差异均有统计学意义(P﹤0.05)。结论 保留盆腔自主神经的RH术式应用于Ⅰ期宫颈癌患者中,虽然手术时间较长,但有利于促进患者术后肠道功能恢复,且对膀胱功能影响较小,可降低术后并发症发生率。Objective To investigate the effects of radical hysterectomy(RH)with and without pelvic autonomic nerve preservation on intestinal and bladder function in patients with stage I cervical cancer.Method According to whether the pelvic autonomic nerve was preserved during operation,105 patients with stage I cervical cancer who underwent laparoscopic RH were divided into preserved group(n=53)and non-preserved group(n=52).The non-preserved group did not preserve the pelvic autonomic nerve during operation,and the preserved group preserved the pelvic auto-nomic nerve during operation.The operative indicators,intestinal function,bladder function[maximum flow rate(MFR),maximal detrusor pressure(MDP),residual urine volume]and postoperative complications were compared between the two groups.Result The operation time of the non-preserved group was shorter than that of the preserved group,the first postoperative exhaust time and first postoperative defecation time were longer than those of the preserved group,the total incidences of intestinal dysfunction and postoperative complications were higher than those of the preserved group,and the differences were statistically significant(P<0.05).One month after operation,the residual urine volume in two groups were higher than those before operation,the MFR and MDP were lower than those before operation,the residual urine volume in non-preserved group was higher than that in preserved group,the MFR and MDP were lower than those in preserved group,and the differences were statistically significant(P<0.05).Conclusion Although the operation time of RH procedure with preservation of pelvic autonomic nerves is longer in patients with stage I cervical cancer,it is beneficial to promote the postoperative intestinal function recovery of patients,and has a small impact on bladder function,which can reduce the incidence of postoperative complications.

关 键 词：宫颈癌 广泛性子宫切除术 盆腔自主神经 肠道功能 膀胱功能 并发症 

分 类 号：R737.33[医药卫生—肿瘤]