腹腔镜下保留盆腔自主神经广泛性子宫切除术对盆底功能的影响

发布时间：2018-04-20 19:13

本文选题：腹腔镜 + 保留神经　；参考：《第三军医大学学报》2017年07期

【摘要】：目的分析比较腹腔镜下保留盆腔自主神经广泛性子宫切除术(laparoscopic nervesparing radical hysterectomy,LNSRH)及传统腹腔镜下广泛性子宫切除术(laparoscopic radical hysterectomy,LRH)两种术式宫颈癌患者术后盆底功能恢复情况,探讨LNSRH对患者盆底功能的影响。方法收集2012-2014年FIGO临床分期为Ⅰb1~Ⅱa2期、于我院接受LNSRH(观察组,n=138)和LRH(对照组,n=138)的宫颈癌患者的临床资料,进行回顾性队列研究,比较两组患者的手术时间、术中出血量、淋巴结切除数目、阴道壁切除长度、住院时间和并发症情况,观察两种手术对患者术后膀胱、直肠及生活质量的影响。结果患者均顺利完成手术,两组患者的手术时间、术中出血量、淋巴结切除数目、阴道壁切除长度、死亡率及复发率比较差异均无统计学意义(P0.05);与LRH组比较,LNSRH组术后住院时间、肛门排气时间及排便时间均缩短,术后泌尿系统并发症(34.8%vs 71.0%)及消化系统并发症(21.7%vs 49.3%)均减少,差异有统计学意义(P0.05);LNSRH组留置尿管天数主要集中在7~14 d,而LRH组主要集中在15 d,差异有统计学意义(P0.05);LNSRH组术后尿失禁生活质量问卷(incontinence quality of life questionnaire,I-QOL)及盆底障碍影响简易问卷7(pelvic floor impact questionnaire 7,PFIQ-7)评分均优于LRH组(P0.05)。结论 LNSRH作为早期宫颈癌手术治疗方式,可保护患者术后膀胱、直肠等盆底器官功能,并在一定程度上提高患者术后生活质量。
[Abstract]:Objective to analyze and compare the pelvic floor function recovery of two kinds of cervical cancer patients with laparoscopic radical hysterectomy (laparoscopic nervesparing radical hysterectomy, LNSRH) and conventional laparoscopic extensive hysterectomy (laparoscopic radical hysterectomy, LRH), and to explore the effect of LNSRH on the pelvic floor. Methods the effect of bottom function. Methods the clinical data of 2012-2014 years FIGO clinical stage I b1~ II A2 were collected, and the clinical data of the patients with cervical cancer in our hospital received LNSRH (observation group, n=138) and LRH (control group, n=138) were reviewed. The operative time, the amount of intraoperative bleeding, the number of lymph node excision, the length of vaginal wall excision, the length of the vaginal wall resection, and the hospitalization were compared. The effects of two kinds of operation on bladder, rectum and quality of life after operation were observed. The results were all successfully completed. There was no significant difference in the time of operation, the amount of bleeding, the number of lymph nodes, the length of the vaginal wall, the mortality and the recurrence rate of the two groups (P0.05), and compared with the group LRH, LNS In group RH, the time of hospitalization, the time of anus exhaust and the time of defecation were shortened. The postoperative urinary system complications (34.8%vs 71%) and the digestive system complications (21.7%vs 49.3%) were reduced, the difference was statistically significant (P0.05); the number of indwelling catheter days in group LNSRH was mainly concentrated in 7~14 D, while LRH group was mainly concentrated in 15 d, and the difference was statistically significant (P0.05). The quality of life questionnaire (incontinence quality of life questionnaire, I-QOL) and pelvic floor disorder after operation in group LNSRH were superior to that of simple questionnaire 7 (pelvic floor impact questionnaire 7, PFIQ-7). Function and improve the quality of life of patients to a certain extent.

【作者单位】：第三军医大学西南医院妇产科;
【分类号】：R713;R737.33

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