腹腔镜QM-C1型广泛性子宫切除术与腹腔镜广泛性子宫切除术的比较研究  

Comparative Study of Laparoscopic QM-C1 Hysterectomy and Radical Hysterectomy

作　　者：黄浩[1,2] 焦燕 韩芳 Huang Hao;Jiao Yan;Han Fang(Department of Gynecology,Sixth Affiliated Hospital of South China University of Technology,Foshan Nanhai District People’s Hospital,Foshan 528000,China;Department of Gynecology,Foshan Fosun Chan Cheng Hospital,Foshan 528000,China)

机构地区：[1]华南理工大学附属第六医院佛山市南海区人民医院妇科,佛山528000 [2]佛山复星禅诚医院妇科,佛山528000

出　　处：《中国微创外科杂志》2025年第1期14-20,共7页Chinese Journal of Minimally Invasive Surgery

基　　金：佛山市科技创新项目-医学科技创新平台建设项目(FSOAA-KJ218-1301-0037)。

摘　　要：目的比较腹腔镜QM-C1型保留盆腔自主神经的广泛性子宫切除术(laparoscopic nerve-sparing radical hysterectomy,LNSRH)与腹腔镜广泛性子宫切除术(laparoscopic radical hysterectomy,LRH)治疗早期宫颈癌术后早期膀胱、直肠功能恢复情况,并总结识别和保留盆腔自主神经的经验。方法从华南理工大学附属第六医院佛山市南海区人民医院和佛山复星禅诚医院回顾性收集2009年9月~2023年9月早期宫颈癌200例LNSRH和160例LRH资料。对比2组术后膀胱与直肠功能恢复情况。结果与LRH组相比,LNSRH组住院时间短[(9.3±2.2)d vs.(11.0±2.4)d,t=-7.688,P<0.001],术后解除尿管早[(7.9±1.2)d vs.(15.7±2.6)d,t=-39.023,P<0.001],尿潴留发生率低(5例vs.23例,χ^(2)=17.475,P<0.001),其他膀胱功能障碍症状(包括夜尿、排尿困难、尿失禁和尿频/尿急)少(6例vs.30例,χ^(2)=24.500,P<0.001),排气早[(24.7±7.1)h vs.(32.4±4.4)h,t=-13.165,P<0.001]。结论与传统LRH相比,LNSRH有效地降低早期宫颈癌患者术后膀胱与直肠功能障碍的风险,促进更快的功能恢复。Objective To evaluate the recovery of bladder and rectal functions after Querleu-Morrow type C1 laparoscopic nerve-sparing radical hysterectomy(LNSRH)and laparoscopic radical hysterectomy(LRH)in the management of early-stage cervical cancer,and summarize the experience of identifying and preserving pelvic autonomic nerves.Methods We retrospectively analyzed data from 200 patients undergoing LNSRH and 160 patients undergoing LRH for early cervical cancer between September 2009 and September 2023 in two hospitals.The postoperative recovery of bladder and rectal functions was compared between the two groups.Results The LNSRH group exhibited a significantly shorter hospital stay[(9.3±2.2)d vs.(11.0±2.4)d,t=-7.688,P<0.001]and earlier removal of urinary catheters[(7.9±1.2)d vs.(15.7±2.6)d,t=-39.023,P<0.001]as compared to the LRH group.Additionally,there was a lower incidence of urinary retention(5 cases vs.23 cases,χ^(2)=17.475,P<0.001)and fewer symptoms of bladder dysfunction,such as nocturia,dysuria,urinary incontinence,and urgency(6 cases vs.30 cases,χ^(2)=24.500,P<0.001)in the LNSRH group.Moreover,the time to recovery of intestinal function postoperatively was significantly reduced[(24.7±7.1)h vs.(32.4±4.4)h,t=-13.165,P<0.001]in the LNSRH group.Conclusion LNSRH appears to significantly enhance the recovery of bladder and rectal functions and reduces the duration of hospital stay as compared to conventional LRH.

关 键 词：宫颈癌 Querleu-Morrow C1型手术 腹腔镜保留盆腔自主神经的广泛性子宫切除术 腹腔镜广泛性子宫切除术 

分 类 号：R713.42[医药卫生—妇产科学]