Objective To analyze the effect of laparoscopic nerve sparing radical hysterectomy (LNSRH) with pelvic autonomic nerve preservation on postoperative quality of life in middle-aged patients with cervical cancer and to explore its clinical value.Methods One hundred and seventy-three cases of middle age cervical cancer treated in the Southwest Hospital of Army Military Medical University from July 2014 to July 2016 were analyzed retrospectively.According to the surgical procedure for the treatment of patients,89 cases received LNSRH were included into the LNSRH group,while 84 patients treated with the conventional laparoscopic radical hysterectomy (LRH) were enrolled into LRH group.The situation of operation,recovery and complications of patients were compared between the two groups,and the cervical cancer function evaluation system (FACT-Cx) was used to evaluate the changes of life quality before and 6 months after surgery.Results The operative time in LNSRH group was longer than that in LRH group,and the difference was statistically significant (P ＜ 0.05).There was no significant difference in the amount of bleeding and lymph node dissection between the two groups (P ＞ 0.05).The indwelling time,residual urine volume,exhaust time and defecation time of LNSRH group were all lower than that in LRH group,and the differences were statistically significant (P ＜ 0.05).The incidence of urinary retention in LNSRH group was lower than that in LRH group,and the difference was statistically significant (P ＜ 0.05).In LNSRH group,there was no significant change in quality of life 6 months after operation (P ＞ 0.05).The scores of additional attention items and FACT-Cx total score 6 months after operation in LRH group were significantly lower than those in preoperative group (P ＜ 0.05).Conclusion The LNSRH surgery can effectively avoid pelvic nerve injury,shorten the postoperative function recovery of bowel and bladder,reduce postoperative complication risk and mitigate the adverse effects of surgery on the quality of life,is a safe and effective operation,worthy of promotion.%目的 分析保留盆腔自主神经的根治性子宫切除术(LNSRH)对中年宫颈癌患者术后生活质量的影响,探讨其临床价值.方法 选取2014年7月～2016年7月陆军军医大学附属西南医院收治的173例中年宫颈癌患者,进行回顾性分析.按照治疗术式将接受LNSRH的89例患者纳入LNSRH组,将接受常规腹腔镜根治性子宫切除术(LRH)的84例患者纳入LRH组.比较两组患者手术情况、恢复情况及并发症发生情况,并运用宫颈癌治疗功能评价系统(FACT-Cx)评价患者术前以及术后6个月生活质量变化.结果 LNSRH组手术时间长于LRH组,差异有统计学意义(P＜0.05);两组患者术中出血量、淋巴结清扫数量比较,差异无统计学意义(P＞0.05).LNSRH组尿管留置时间、术后残余尿量、排气时间、排便时间均低于LRH组,差异有统计学意义(P＜0.05).LNSRH组术后尿潴留发生率低于LRH组,差异有统计学意义(P＜0.05).LNSRH组术后6个月生活质量未见明显变化(P＞0.05);LRH组术后6个月附加关注条目得分及FACT-Cx总分均较术前降低,差异有统计学意义(P＜0.05).结论 LNSRH术式能够有效避免盆腔神经损伤,缩短术后膀胱及直肠功能恢复时间、降低术后并发症发生风险、减轻手术对患者生活质量带来的不良影响,是一种安全、有效的术式,值得推广.
展开▼
