腹腔镜结直肠癌根治术对结直肠癌患者尿动力学指标及性功能的影响

摘要

目的 探讨腹腔镜结直肠癌根治术对男性结直肠癌患者尿动力学指标及性功能的影响.方法 选择2013年9月至2016年8月南通市通州区人民医院普外科收治的男性结直肠癌患者55例为研究对象,根据入院时间按照单双号分为观察组29例和对照组26例.观察组行腹腔镜结直肠癌根治术,对照组行传统开腹结直肠癌根治术.以术后恢复情况、尿动力学及性功能等作为评价指标.结果 术后1周,观察组患者术后下床活动时间、术后排气时间、术后进食时间、住院时间分别为(6.35±0.74)h、(25.11±3.34)h、(17.43±1.66)h和(7.32±0.56)d,均明显短于对照组的(10.42±1.21)h、(47.63±5.48)h、(40.28±5.54)h和(10.64±0.75)d,组间比较差异均有统计学意义(P<0.05);观察组患者的最大尿流量、最大排尿压、排尿期逼尿肌收缩压分别为(24.01±3.59)mL/s、(7.03±0.68)kPa、(5.85±0.44)kPa,均明显高于对照组的(18.24±2.61)mL/s、(5.24±0.65)kPa、(4.52±0.29)kPa,而残余尿量为(3.85±0.34)mL,明显低于对照组的(6.21±0.79)mL,组间比较差异均有统计学意义(P<0.05);术后随访6个月,观察组患者的国际勃起功能指数问卷调查表(IIEF)评分为(18.12±2.14)分,明显高于对照组的(11.68±1.24)分,射精功能障碍发生率为17.24％,明显低于对照组的42.31％,组间比较差异均有统计学意义(P<0.05).结论 腹腔镜结直肠癌根治术有助于减少手术对患者排尿功能和性功能的损伤,促进患者术后恢复.%Objective To investigate the effect of laparoscopic radical resection of colorectal cancer on urody-namic indexes and sexual function in male colorectal cancer patients. Methods Fifty-five male colorectal cancer pa-tients were selected from September 2013 to August 2016 in Nantong Tongzhou District People 's Hospital. According to the admission time in accordance with the odd and even numbers, the patients were randomly divided into observation group (29 cases) and control group (26 cases). The patients in the observation group underwent laparoscopic radical re-section of colorectal cancer, and the control group was treated with traditional open radical resection. Postoperative re-covery, urodynamic indexes and sexual function were evaluated. Results At 1 week after operation, the time of ambula-tion, postoperative exhaust time, postoperative eating time and hospitalization time were (6.35±0.74) h, (25.11±3.34) h, (17.43±1.66) h and (7.32±0.56) d, significantly shorter than (10.42±1.21) h, (47.63±5.48) h, (40.28±5.54) h and (10.64± 0.75) d in the control group (P<0.05). The maximum urinary flow, maximal voiding pressure, maximum cystometric ca-pacity, residual urine volume were (24.01±3.59) mL/s, (7.03±0.68) kPa, (5.85±0.44) kPa, (3.85±0.34) mL in the observa-tion group, versus (18.24±2.61) mL/s, (5.24±0.65) kPa, (4.52±0.29) kPa, (6.21±0.79) mL in the control group (P<0.05). The patients were followed up for 6 months. The score of the International Erectile Index Index (IIEF) was (18.12 ± 2.14) in the observation group, which was significantly higher than (11.68 ± 1.24) in the control group. The incidence of ejaculation dysfunction in the observation group was 17.24％, which was significantly lower than 42.31％in the control group. There were significant differences between the two groups (P<0.05). Conclusion Laparoscopic radical resec-tion of colorectal cancer can help reduce the damage of operation to voiding function and sexual function, and promote postoperative recovery.