腹腔镜下保留盆腔自主神经的广泛性子宫切除术治疗早期宫颈癌的安全性及疗效的临床研究

发布时间：2018-02-06 07:21

本文关键词： 腹腔镜保留神经宫颈癌广泛性子宫切除术　出处：《实用妇产科杂志》2016年10期 　论文类型：期刊论文

【摘要】：目的:评估腹腔镜下保留盆腔自主神经的广泛性子宫切除术(LNSRH)治疗早期宫颈癌的安全性及疗效。方法:回顾性分析行广泛性子宫切除术的宫颈癌患者235例的临床资料,根据手术方式不同,分为LNSRH组116例,普通腹腔镜下广泛性子宫切除术组(LRH组)119例,比较两组的手术参数(包括手术时间、术中出血量、术中及术后并发症、宫旁切除长度、阴道切除长度、淋巴结切除数目),及术后的膀胱功能恢复指标(包括留置尿管天数、术后有无尿频、尿急、尿痛、腹压排尿、尿失禁、尿潴留以及排尿满意率),采用Kaplan-Meier法比较两组术后生存时间分布。结果:两组患者的各项手术参数比较,差异无统计学意义(P0.05);LNSRH组术后留置尿管天数、膀胱功能障碍发生率、腹压排尿、尿潴留以及排尿满意率明显优于LRH组,差异有统计学意义(P0.05);LNSRH组和LRH组术后5年生存率分别为86.4%和89.1%,术后生存时间分布差异无统计学意义(P0.05)。结论:LNSRH治疗早期宫颈癌是安全可靠的,与LRH比较,有较好的膀胱功能保护作用。
[Abstract]:Objective: to evaluate LNSRH in laparoscopic pelvic autonomic nerve preserving extensive hysterectomy. Methods: the clinical data of 235 patients with cervical cancer undergoing extensive hysterectomy were retrospectively analyzed. According to the different operation methods, the patients were divided into LNSRH group (116 cases) and general laparoscopic hysterectomy group (119 cases). The operation parameters (including operation time) were compared between the two groups. Intraoperative bleeding, intraoperative and postoperative complications, length of para-uterine resection, length of vaginal resection, number of lymph nodes resection, and postoperative bladder function recovery index (including days of indwelling urethral catheter, frequency of urination after operation, urgency of urination). Urinary pain, abdominal pressure urination, urinary incontinence, retention of urine and satisfaction rate of urination were compared by Kaplan-Meier. Results: the operative parameters of the two groups were compared. The difference was not statistically significant (P 0.05). The days of indwelling catheter, the incidence of bladder dysfunction, abdominal pressure urination, retention of urine and satisfaction rate of urination in LNSRH group were significantly better than those in LRH group (P 0.05). The 5-year survival rate of LNSRH group and LRH group were 86.4% and 89.1% respectively. Conclusion it is safe and reliable to treat early cervix carcinoma with LRH, and it has a better protective effect on bladder function than that of LRH.
【作者单位】：第三军医大学附属西南医院;
【分类号】：R737.33

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