[1]张灿英,娄艳辉,崔竹梅,等. 腹腔镜下保留盆腔自主神经的根治性全子宫切除术与术后膀胱功能恢复的相关性[J].青岛大学学报(医学版),2018,54(03 ):309-312.[doi:10.11712/jms201803013]
 ZHANG Canying,LOU Yanhui,CUI Zhumei,et al. EFFECT OF LAPAROSCOPIC NERVE-SPARING RADICAL HYSTERECTOMY ON BLADDER FUNCTION IN PATIENTS WITH CERVICAL CANCER[J].JOURNAL OF QINGDAO UNIVERSITY (MEDICAL SCIENCES),2018,54(03 ):309-312.[doi:10.11712/jms201803013]
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 腹腔镜下保留盆腔自主神经的根治性全子宫切除术与术后膀胱功能恢复的相关性()
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《青岛大学学报(医学版)》[ISSN:2096-5532/CN:37-1217/R]

卷:
第54卷
期数:
2018年03 期
页码:
309-312
栏目:
出版日期:
2018-05-29

文章信息/Info

Title:
 EFFECT OF LAPAROSCOPIC NERVE-SPARING RADICAL HYSTERECTOMY ON BLADDER FUNCTION IN PATIENTS WITH CERVICAL CANCER
作者:
 张灿英1娄艳辉2崔竹梅2王灵芝2项丽2
 青岛大学,山东 青岛 266021 1 妇科学专业研究生; 2 附属医院妇科
Author(s):
 ZHANG Canying LOU Yanhui CUI Zhumei WANG Lingzhi XIANG Li
 Graduate Student of Gynecology, Qingdao University Medical College, Qingdao 266021, China
关键词:
 宫颈肿瘤自主神经子宫切除术腹腔镜检查膀胱排尿障碍治疗结果
Keywords:
 uterine cervical neoplasms autonomic nerves hysterectomy laparoscopy urinary bladder urination disorders traatment outcome
分类号:
RR713.42
DOI:
10.11712/jms201803013
文献标志码:
A
摘要:
 目的 探讨腹腔镜下保留盆腔自主神经的根治性全子宫切除术(LNSRH)与病人术后膀胱功能恢复之间的相关性及该手术的可行性。
方法 选取66例因宫颈癌于青岛大学附属医院行手术治疗的病人,根据手术方式分为2组,研究组30例行LNSRH,对照组36例行传统的腹腔镜下根治性全子宫切除术(LRH)。比较两组病人的手术参数(手术时间、术中出血量、术中切除子宫韧带和阴道前后壁长度等)以及术后7 d的排尿情况(顺利拔除尿管、残余尿量及腹压排尿情况),并于术后1、3、6、9、12、18个月随访,记录两组病人的膀胱功能恢复情况。
结果 研究组手术时间长于对照组,差异有统计学意义(t=6.14,P<0.05);两组其他手术参数比较差异均无统计学意义(P>0.05)。术后7 d,研究组和对照组顺利拔除尿管病人所占的比例分别为66.67%和28.78%,差异有统计学意义(χ2=5.76,P<0.05);残余尿量分别为(80.46±33.94)、(122.61±43.67)mL,差异有统计学意义(t=6.32,P<0.05)。术后随访,研究组病人的膀胱功能恢复情况(留置尿管时间、尿感恢复时间、腹压排尿持续时间)优于对照组(χ2=2.76~5.35,t=6.78~9.73,P<0.05)。
结论 行LNSRH病人术后膀胱功能恢复情况优于行LRH者,盆腔神经的保留与病人术后排尿功能有相关性。LNSRH对解决病人的排尿功能障碍有一定的效果,具有可行性。
Abstract:
 Objective To investigate the effect of laparoscopic nerve-sparing radical hysterectomy (LNSRH) on bladder function and the feasibility of the surgical procedure in patients with cervical cancer.
Methods Sixty-six patients who underwent surgical treatment for cervical cancer in the Affiliated Hospital of Qingdao University were divided into study group (n=30) and control group (n=36). The study group underwent LNSRH, while the control group underwent conventional laparoscopic radical hysterectomy (LRH). The following indices were compared between the two groups: surgical parameters (operation time, intraoperative blood loss, length of resected uterine ligament, and lengths of resected anterior and posterior vaginal walls), urination indices at 7 d after surgery (successful catheter withdrawal, residual urine volume, and whether abdominal pressure is necessary to urination or not), and bladder function recovery at 1,3,6,9,12, and 18 months after surgery.
Results The study group had a significantly longer operation time than the control group (t=6.14,P<0.05). However, there were no significant differences in other surgical parameters between the two groups (P>0.05). At 7 d after surgery, there were significant differences in the proportion of patients with successful catheter withdrawal and the residual urine volume between the study group and the control group (66.67% vs 28.78%, χ2=5.76,P<0.05; (80.46±33.94) mL vs (122.61±43.67) mL, t=6.32,P<0.05). After the follow-up, the study group had significantly better bladder function recovery (time to catheter withdrawal, time to urine recovery, and time to urination without abdominal pressure) than the control group (χ2=2.76-5.35,t=6.78-9.73,P<0.05).
Conclusion For patients with cervical cancer, LNSRH can achieve better bladder function recovery than LRH. The postoperative urinary function is associated with the retention of pelvic nerves. LNSRH is a feasible surgical procedure to alleviate urinary dysfunction in patients with cervical cancer.
更新日期/Last Update: 2018-06-05