摘要
目的探讨腹腔镜下保留盆腔自主神经根治性子宫切除术对降低膀胱功能障碍并发症作用以及其安全性和可行性。方法对2008年9月—2012年9月在本院住院IA2-IB2期宫颈癌患者42例实施腹腔镜下保留神经的根治性子宫切除术(LNSRH组),42例实施腹腔镜下子宫根治术而未保留盆腔自主神经(LRH组)。观察2组术中的出血量、手术时间及术后膀胱功能恢复情况等指标。结果所有患者均完成了保留盆腔自主神经根治性子宫切除术。LRH组仅1例患者术中发生膀胱损伤并在腹腔镜下完成了修补。LNSRH组的手术时间为(240±34)min,明显长于LRH组的(186±35)min(P<0.05);2组术中出血量、切除盆腔淋巴结的数目、切除宫旁组织长度、阴道长度比较均无显著差异(P>0.05);LNSRH组的术后尿管拔除时间为(7.4±2.5)d,明显短于LRH组的(17.6±7.6)d(P<0.05)。结论腹腔镜下保留盆腔自主神经的根治性子宫切除术能够降低手术对膀胱功能的损伤,促进术后膀胱功能的恢复。
Objective To explore the feasibility and safety of autonomic nerve-spanng rach- cal hysterectomy under laparoscope, and its impact on reducing the complications of bladder dys- function. Methods A total of 84 patients with IA2 and 1B2 cervical cancer from September 2008 to September 2012 were divided into LNSRH group and LRH group. There were 42 patients conduct- ed with laparoscopie nerve-sparing radical hysterectomy in the LNSRH group while another 42 pa tients applied laparoscopic radical hysterectomy without nerve preservation in the LRH group. A se- ries of indexes in blooding amount, operation time as well as the recovery of bladder function were observed in the research. Results The laparoscopic nerve-sparing radical hysterectomy was complet- ed in all of the patients. There was only one patient accompanying by bladder impairment and was completed the neoplasty under laparoscope in LRH group. The operation time of LNSRH group with 240 ± 34 minutes was much longer than that in LRH group with 186 ± 35 minutes（P〈0.05）. However, there were no significant differences of blood loss, the amount of lymph nodes, length of parametrium and length of vaginal in the two groups （P 〉0.05）. Compared with the extract time of urinary catheter in LRH group with （17.6 ±7.6） days, the time in LNSRH group lasting （7.4 ± 2.5） days was shorter （P 〈 0.05）. Conclusion The research revealed that laparoscopic auto- nomic nerve-sparing radical hysterectomy could reduce the incidence of bladder dysfunction and is conductive to the postoperative recovery of bladder function.
出处
《实用临床医药杂志》
CAS
2013年第24期68-71,共4页
Journal of Clinical Medicine in Practice
关键词
宫颈癌
保留神经
子宫根治术
腹腔镜
cervical cancer
nerve-sparing
radical hysterectomy
laparoscope
