论文部分内容阅读
[目的]探讨开腹下实施保留盆腔自主神经平面(nerve sparing radical hysterectomy,NSRH)同时保留卵巢手术对早期宫颈癌的临床价值,并与传统广泛性子宫切除术(conventional radical hysterectomy,CRH)进行对比,探究NSRH的临床价值。[方法 ]100例接受手术治疗的宫颈癌患者分为4组,其中A组接受NSRH并原位保留卵巢,B组接受NSRH并卵巢移位,C组接受CRH并原位保留卵巢,D组接受CRH并卵巢移位患者,每组各25例,均为Ⅰb~Ⅱa1期,手术中4例NSRH患者保留自主神经平面失败,归入CRH,观察并比较4组患者的术后情况。[结果]对于4组患者采用单一变量两两比较的原则,分别比较A组与C组,B组与D组的手术时间、出血量、清扫盆腔淋巴结数、宫旁组织切除长度、阴道切除长度等方面,差异均无统计学意义(P>0.05);分别比较A与B组,C与D组术前及术后6个月的卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)值,差异无统计学意义(P>0.05)。[结论]在NSRH手术中保留卵巢安全可靠,不仅与CRH手术相比有明显优势,对改善患者术后膀胱功能、直肠功能,保留卵巢内分泌功能和提高患者术后生活质量有明显作用,并且术后6个月并发率低,具有重大的临床意义。
[Objective] To explore the clinical value of open radical nerve preservation of pelvic autonomic nerve (NSRH) while preserving ovarian surgery for early cervical cancer and to compare with traditional radical hysterectomy (CRH) , To explore the clinical value of NSRH. [Methods] 100 cases of cervical cancer undergoing surgical treatment were divided into 4 groups: group A received NSRH and retained ovary in situ; group B received NSRH and ovarian metastasis; group C received CRH and retained ovary in situ; group D received CRH and ovarian transposition patients, each group of 25 cases, all Ⅰb ~ Ⅱ a1, 4 cases of NSRH surgery patients with autonomic nerve plane failure, classified as CRH, were observed and compared postoperative patients in 4 groups. [Results] The four groups of patients using the principle of single variable comparison of each two, respectively, A group and C group, B group and D group operation time, blood loss, pelvic lymph node dissection number, parauterum resection length, resection length (P> 0.05). The levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), and females in groups A and B, C and D before and 6 months after surgery were compared respectively Diol (E2) value, the difference was not statistically significant (P> 0.05). [Conclusion] It is safe and reliable to keep the ovary in NSRH operation. It not only has obvious advantages compared with CRH operation, but also has obvious effect on improving bladder function, rectal function, preserving the ovarian endocrine function and improving postoperative quality of life. Six months after the low incidence, with great clinical significance.