腹腔镜下保留神经的广泛子宫切除术治疗宫颈癌52例临床效果分析

摘要

目的探讨腹腔镜下保留神经的广泛子宫切除术治疗宫颈癌的临床效果。方法选择我院2009年6月～2010年6月76例早期宫颈癌患者根据治疗方法分为两组，观察组38例患者采用保留神经的广泛子宫切除术，对照组38例患者采用腹腔镜下广泛性子宫切除术，观察两组患者平均手术时间、平均住院时间、术中出血量及直肠、膀胱功能恢复情况，所有患者均随访6～24个月，对复发及转移情况进行观察。结果观察组平均手术时间为（325.5±74.5）min，比对照组时间长，平均住院时间为（11.5±3.5）h，短于对照组，观察组拔出尿管时间、术后排气时间、术中排便时间均短于对照组，两组比较差异有统计学意义（P＜0.05）。两组术中平均出血量比较差异无统计学意义（P＞0.05）。所有患者均得到6～24个月的随访，经超声及妇科检查，无一例阴道残端及腹壁穿刺口复发的病例。结论腹腔镜下保留神经的广泛子宫切除术可以提高患者的预后，有利于术后膀胱、直肠功能的恢复，是宫颈癌手术的首选方法。%Objective To discuss the clinical effect of laparoscopic nerve-sparing radical hysterectomy (LNSRH) in the treatment of cervical carcinoma. Methods The clinical data of 76 early cervical cancer patients who were in hospital between June 2009 to June 2010 were retrospectively analyzed.All patients were divided into the control group and the experiment group according to the treatment method, each group of 38 cases. The experiment group was treated by laparoscopic nerve-sparing radical hysterectomy, and the control group was treated by laparoscopic radical hysterectomy. The average operation time,average stay, intraoperative bleeding and recovery of rectum and bladder function were observed. All patients were followed up for 6-24 months, and observed with the relapse and metastasis. Results The average operation time of experiment group was (325.5±74.5)min, longer than that of control group, and the average hospitalization time of experiment group was (11.5±3.5)h, shorter than that of control group. Pull out the catheter time, postoperative exhaust time, and intraoperative defecation time of experiment group were shorter than those of control group with statistically significant difference (P<0.05). The average intraoperative bleeding of two groups had no significant difference (P>0.05). All patients were followed up for 6-24 months, and no case had vaginal stump and abdominal puncture recurrence through ultrasound and gynecological examination. Conclusion The laparoscopic nerve-sparing radical hysterectomy can improve the prognosis of patients and would be propitious to recovery of bladder and rectum function after surgery. It's the preferred method for cervical cancer operation.