腹腔镜下完成宫颈癌保留神经平面广泛子宫切除术可行性分析.docVIP

腹腔镜下完成宫颈癌保留神经平面广泛子宫切除术可行性分析 　　[摘要] 目的 分析腹腔镜下完成宫颈癌保留神经平面广泛子宫切除术（NPSRH）的可行性。 方法 选取2013年4月～2014年7月在江苏省新沂市人民医院行宫颈癌手术的88例患者。根据手术方法进行分组，对照组32例实施非保留神经平面广泛子宫切除术，实验组56例实施NPSRH，对两组患者的手术指标和膀胱、直肠功能指标情况以及不良反应发生率进行比较分析。 结果 实验组手术时间和术中出血量显著高于对照组，恢复时间和并发症发生率显著低于对照组，差异均有统计学意义（P 0.05）；实验组排气时间、留置尿管时间、排尿间隔时间显著低于对照组，最大尿流率显著高于对照组，差异均有统计学意义（P 0.05）；实验组术后远期不良反应发生率显著低于对照组，差异有统计学意义（P 0.05）。实验组Ⅰ期及Ⅱa期子宫颈癌患者3年生存率均为25.0%（14例），Ⅱb期子宫颈癌患者为44.6%（25例），均明显高于对照组Ⅰ期子宫颈癌[2.5%（14例）]、Ⅱb期子宫颈癌患者[5例（15.6%）]以及Ⅱb期的子宫颈癌患者[25.0%（8例）]，差异均有统计学意义（P 0.05）。 结论 在腹腔镜下采用NPSRH治疗宫颈癌可行性强，临床功能恢复良好。 　　[关键词] 宫颈癌；腹腔镜；保留神经平面广泛子宫切除术；临床效果 　　[中图分类号] R713.4 [文献标识码] A [文章编号] 1673-7210（2015）01（b）-0046-05 　　[Abstract] Objective To analyze feasibility of completing cervical cancer nerve-sparing plane radical hysterectomy （NPSRH） in laparoscopic. Methods 88 cases of patients with implementation of cervical cancer surgery in the Peoples Hospital of Xinyi City from April 2013 to July 2014 were selected， and according to surgical methods， they were divided into 32 cases of control group of non-nerve-sparing plane radical hysterectomy， 56 cases of the experimental group of implement a wide range of uterine NPSRH， surgical indicators and bladder， rectum function parameters as well as the incidence of adverse reactions of patients in two groups were compared with survival. Results The operative time and blood loss in the experimental group were significantly higher， and the recovery time and complication rate was significantly lower than those of the control group， the differences were statistically significant （P 0.05）； exhaust time， indwelling catheter time， voiding interval in the experimental group were significantly lower than those of the control group， and the maximum flow rate was significantly higher， the differences were statistically significant （P 0.05）； long-term adverse effects after surgery in the experimental group were significantly lower than those of the control group， the differences were statistically significant