腹腔镜下保留盆腔自主神经的广泛子宫切除术对直肠及膀胱功能保护效果的研究

发布时间：2018-04-04 16:19

本文选题：子宫切除术　切入点：保留盆腔自主神经　出处：《中国内镜杂志》2015年04期

【摘要】：目的分析腹腔镜下保留盆腔自主神经的广泛子宫切除术对腹腔冲洗液中MMP含量以及术后直肠和膀胱功能的影响。方法选择在该院接受广泛子宫切除术治疗的108例宫颈癌患者作为研究对象,随机分为保留盆腔自主神经的观察组以及切除盆腔自主神经的对照组,比较两组患者的手术相关指标、腹腔冲洗液MMP含量以及直肠和膀胱功能障碍发生情况的差异。结果观察组患者接受治疗后的手术时间长于对照组患者,术后排气时间、排便时间、留置尿管时间及住院时间短于对照组患者(P0.05)。观察组患者接受治疗后的腹腔冲洗液MMP-2及MMP-9含量均明显低于对照组患者(P0.05)。观察组患者接受治疗后的直肠功能障碍及膀胱功能障碍发生率均显著低于对照组患者(P0.05)。结论腹腔镜下保留盆腔自主神经的广泛子宫切除术有助于促进患者术后康复,减少MMP产生,同时避免患者术后出现直肠及膀胱功能障碍。
[Abstract]:Objective to analyze the effects of laparoscopic extensive hysterectomy with pelvic autonomic nerve preservation on the content of MMP in peritoneal lavage fluid and postoperative rectal and bladder function.Methods 108 patients with cervical cancer undergoing extensive hysterectomy in our hospital were randomly divided into observation group with pelvic autonomic nerve preservation and control group with pelvic autonomic nerve resected.The differences of surgical parameters, MMP content in peritoneal lavage fluid and the incidence of rectum and bladder dysfunction were compared between the two groups.Results the operative time after treatment in the observation group was longer than that in the control group, and the time of exhaust, defecation, indwelling urinary catheter and hospitalization was shorter than that of the control group (P 0.05).The contents of MMP-2 and MMP-9 in the peritoneal lavage fluid in the observation group were significantly lower than those in the control group (P 0.05).The incidence of rectal dysfunction and bladder dysfunction in the observation group was significantly lower than that in the control group (P 0.05).Conclusion extensive hysterectomy with pelvic autonomic nerve preservation under laparoscope can promote postoperative recovery, reduce MMP production, and avoid postoperative rectal and bladder dysfunction.
【作者单位】：武汉科技大学医院妇产科;武汉大学中南医院妇产科;
【分类号】：R737.33

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