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保留盆腔神经宫颈癌根治术与传统宫颈癌根治术的比较研究
引用本文:唐修武,孙云,倪观太.保留盆腔神经宫颈癌根治术与传统宫颈癌根治术的比较研究[J].中国临床药理学与治疗学,2013(10):1148-1154.
作者姓名:唐修武  孙云  倪观太
作者单位:皖南医学院第一附属医院妇产科,安徽芜湖241001
摘    要:目的:探讨保留盆腔自主神经的宫颈癌根治术与传统宫颈癌根治术对患者术后生活质量的影响及其手术效果的初步评估。方法:选择皖南医学院第一附属医院2011年1月至2012年09月收治的经国际妇产科学联盟(FIGO)分期为IB~ⅡA的子宫颈癌患者50例,设研究组(n=20)采用保留盆腔自主神经的宫颈癌根治术,对照组(n=30)行传统的宫颈癌根治术,比较两组手术范围、手术时间、术中出血量、导尿管保留天数、残余尿量、肛门排气、排便时间及术后半年性功能恢复情况。结果:对照组与研究组比较,术后第10天残余尿量分别为(201.83±83.00)、(139.75±69.01)mL,保留尿管天数(15.20±2.43)、(11.85±2.08)d;术后肛门排气时间分别为(72.97±16.31)、(59.60±13。37)h,术后肛门排便时间分别为(121.17±23.07)、(91.05±11.66)h,两组相比差异具有统计学意义(P〈0.05);术后半年性功能随访结果显示:对照组性功能障碍的发生率为86.7%,研究组性功能障碍发生率为45%,两组相比差异有统计学意义(P〈0.05),对术后半年未恢复性生活的患者进行原因调查,发现因“害怕疾病复发”占77.8%;害怕“性交病或出血”占55.6%。研究组与对照组手术时间中位数分别为250(180~330)min和200(150~270)min,术中手术时间、出血量、术中切除主骶韧带、阴道长度及淋巴结清扫数目等指标差异均无统计学意义。结论:保留盆腔自主神经的宫颈癌根治术治疗早期宫颈癌是安全可行的,与传统根治术相比更有利于膀胱、直肠功能的恢复,有助于提高患者术后的生活质量。

关 键 词:保留盆腔神经  宫颈癌根治术  生活质    性功能

Comparative study on nerve sparing radical hysterectomy with radical hysterectomy
TANG Xiu-wu,SUN Yun,NI Guan-tai.Comparative study on nerve sparing radical hysterectomy with radical hysterectomy[J].Chinese Journal of Clinical Pharmacology and Therapeutics,2013(10):1148-1154.
Authors:TANG Xiu-wu  SUN Yun  NI Guan-tai
Institution:Department of Gynaecology and Obstetrics,the First Affiliated Hospital of Wannan Medical Col lege , Wuhu 241001 ,Anhui,China
Abstract:To compare the life quality of patients after nerve sparing radical hysterectomy or traditional radical hysterectomy and evalu ate the safety of two operations. METHODS: Fifty patients with cervical cancer of I BⅡ A (FIGO) were selected under the guideline of eth- ic committee. Thirty of them received traditionalradical hysterectomy (RH) as control group and twenty received nerve sparing radical hysterecto my (NSRH)as experimental group. The excision extent, operation time, blood loss, urethral catheter remaining days, residual urine volume, the first exhaust time, defecation time and sexu al function recovery were followed up for half ayear and these data were compared between the two groups. RESULTS: On the tenth day after operation, the residual urine volume of control group and experimental group were (201.83 ± 83.00) mL and (139. 75± 69. 01) mL; the ure thral catheter remaining days of control group was (15.20 ±2.43) d and the experimental group was (11.85 ±2.08) d; the first exhaust time was (72.97±16.31) h and(59.60±13.37) h;the first defecation time was (121.17±23.07) h and (91. 05±11.66) h,there were statistically difference in two groups(P〈0.05). The sexual dysfunction in control group and experimental group control group were 86.7% and 45%re spectively. For six months after operation there were statistically difference between two groups(P〈0.05). 77.8% of patients who didn't re sume intercourse were afraid of relapse and 55. 6 %of them were afraid of pain. The median op-eration time of the two groups were 250 (180- 330) min and 205 (150-270) rain,and there was no statistically difference between two groups in operation time blood loss and excision extent. CONCLUSION: NSRH for the patients with cer vical cancer is feasible and safe and it can im prove the recovery of bladder and rectum func tions, and eventually make contribution to quali ty life of natients.
Keywords:Nerve pelvic sparing  Radicalhysterectomy  Quality life  Sexual function
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