宫颈癌根治性子宫切除术中保留盆腔自主神经的临床疗效探讨

目的探讨宫颈癌根治性子宫切除术中保留盆腔自主神经的临床疗效。方法选择61例宫颈癌患者分成研究组31例和对照组30例。对照组按常规行根治性子宫切除术;研究组在行根治性子宫切除术中保留盆腔膀胱神经丛和直肠神经丛。对比两组的手术总时间、子宫切除时间、术中出血量、术后残余尿量、尿管留置时间、排气及排便时间、性功能分级。结果研究组子宫切除时间为（87.64±16.29）min,对照组为（88.12±14.58）min,（P〉0.05）;研究组术中出血量为（257.81±72.16）mL,对照组为（231.45±75.67）mL,（P〉0.05）;研究组手术总时间（294.23±31.57）min,对照组为（267.15±35.99）min（P〈0.05）;研究组尿管留置时间为（10.26±1.12）d,对照组为（11.28±1.15）d,P〈0.05;研究组残余尿量为（23.05±4.37）mL,对照组为（27.18±4.59）mL,（P〈0.05）;研究组排气时间为（1.25±0.59）d,对照组为（1.87±0.73）d,（P〈0.05）;研究组排便时间（1.85±0.84）d,对照组为（2.66±0.92）d,（P〈0.05）;研究组性功能0、Ⅱ级所占比例为54.84%、3.22%,对照组为30%、23.33%,（P〈0.05）;研究组性功能Ⅰ级所占比例为41.94%,对照组为46.67%,（P〉0.05）。结论宫颈癌根治性子宫切除术中保留盆腔自主神经虽术中耗时稍长,但患者膀胱功能、肠道功能恢复更快,性功能恢复更好。

Discussion on the Clinical Effect of Pelvic Autonomic Nerve Preservation in Radical Resection of Uterine Cervical Cancer

Objective To investigate the clinical effect of pelvic autonomic nerve preservation in radical resection of uterine cervical cancer. Methods 61 cases of cervical cancer patients were divided into study group of 31 cases and control group of 30 cases. The control group was treated by routine radical hysterectomy; the study group was treated by radical hysterectomy and preservation of pelvic nerve plexus in the bladder and rectal plexus. The total operation time, hysterectomy time, intraoperative blood loss, postoperative residual urine volume, indwelling catheter time, exhaust and defecation time, sexual function classification of the two groups were compared. Results The hysterectomy time of the study group was（87.64±16.29）min, and that of the control group was（88.12±14.58）min, P〉0.05;the intraoperative blood loss of the study group was（257.81±72.16）ml, and that of the control group was（231.45±75.67）ml, P〉0.05;the total operation time of the study group was（294.23±31.57）min, and that of the control group was（267.15±35.99）min, P〈0.05;the indwelling catheter time of the study group was（10.26±1.12）d, and that of the control group was（11.28±1.15）d, P〈0.05; the postoperative residual urine volume of the study group was（23.05±4.37）ml, and that of the control group was（27.18±4.59）ml, P〈0.05;the exhaust time of the study group was（1.25±0.59）d, and that of the control group was（1.87±0.73）d, P〈0.05; the defecation time of the study group was（1.85±0.84）d,and that of the control group was（2.66 ±0.92）d, P 0.05;The proportion of patients with sexual function 0 grade, Ⅱ grade of the study group was 54.84%, 3.22%, respectively, and that of the control group was 30%, 23.33%, separately, P〈0.05;The proportion of patients with sexual function gradeⅠwas 41.94%, and that of the control group was 46.67%, P〉0.05. Conclusion Although the operation time of pelvic autonomic nerve preservation in radical resection of uterine cervical cancer is slightl