腹腔镜下保留盆腔自主神经的根治性子宫切除术效果观察

摘要

目的:探讨腹腔镜下保留盆腔自主神经的根治性子宫切除术的临床效果.方法:88例行腹腔镜下根治性子宫切除术的宫颈癌病人随机分为观察组和对照组,各44例.对照组病人给予传统的根治性子宫切除术,观察组病人行腹腔镜下保留盆腔自主神经根治性子宫切除术.比较2组病人的手术时间、术中出血量、阴道及宫旁切除长度、清扫淋巴数、术后拔除尿管的时间、术后残余尿量<100 mL的时间、术后肛门排气及排便时间等指标.结果:2组病人术后均无并发症发生.观察组病人的手术时间长于对照组(P<0.01);观察组病人术后拔除尿管时间、残余尿量<100 mL时间、肛门排气及排便时间均明显短于对照组(P<0.01).结论:腹腔镜下保留盆腔自主神经根治性子宫切除术治疗早期宫颈癌安全性高,有利于病人膀胱及直肠功能的恢复,临床效果显著,值得推广应用.%Objective:To observe the clinical efficacy of the pelvic autonomic nerve-sparing under laparoscopy in radical hysterectomy.Methods:Eighty-eight cervical cancer patients treated with laparoscopic radical hysterectomy were randomly divided into the observation group and control group(44 cases each group).The control group and observation group were treated with the conventional radical hysterectomy and laparoscopic pelvic autonomic nerve-sparing radical hysterectomy,respectively.The operation time,intraoperative bleeding volume,vaginal and uterine resection length,lymph dissection number,postoperative pulling urinary catheter time,postoperative residual urine volume less than 100 mL time,and postoperative anal exhaust and defecation time between two groups were compared.Results:No complications in two groups were found after operation.The operation time in observation group was longer than that in control group(P<0.01).The postoperative pulling urinary catheter time,postoperative residual urine volume less than 100 mL time,and postoperative anal exhaust and defecation time in observation group were significantly shorter those in control group(P<0.01).Conclusions:The pelvic autonomic nerve-sparing under laparoscopy in radical hysterectomy in the treatment of early cervical cancer is safe and highly efficient,which can help to recover the function of bladder and rectum,and is worthy of promotion in clinic.