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目的探讨开腹下实施保留盆腔自主神经平面的广泛性子宫切除术(NSRH)对早期宫颈癌患者直肠功能的影响,并与传统广泛性子宫切除术(CRH)进行对比,探究NSRH的临床价值。方法选择2012年6月-2014年6月该院的30例早期宫颈癌患者,将其分为2组(A组和B组),其中A组患者进行NSRH,B组患者进行CRH,每组各15例,均为ⅠB~ⅡA1期,手术中A组3例患者保留自主神经平面失败,归入B组,观察并记录比较2组患者的术中情况、术后恢复状况和并发症发生情况。结果 A组与B组的手术时间、术中出血量、肿瘤大小、宫旁组织切除长度、阴道切除长度、清扫盆腔淋巴结数等方面进行比较差异均无统计学意义(t值分别为1.713、1.381、1.047、2.014 3、1.973、1.479 2,P>0.05)。A组术后尿管留置时间、术后自主排气时间、术后自主排便时间明显短于B组,A组10 d后残余尿量少于B组,差异均具有统计学意义(t值分别为13.287、9.367 1、16.727 1、27.468,P<0.05)。术后回访调查6个月,在B组仍有3例存在尿频、尿急、尿路感染等症状,A组不存在这些情况。A组术后并发症发生率明显低于B组,差异具有统计学意义(χ~2值分别为1.766 2、5.477 2、0.017、0.562、8.711,P<0.05)。结论 NSRH安全可靠,与CRH相比不仅有明显优势,对改善患者术后直肠功能和膀胱功能有显著意义,而且对提高患者术后生活质量有明显作用,并且术后6个月并发症发生率低,具有重大的临床意义。
Objective To investigate the effect of open radical hysterectomy (NSRH) on the rectal function of patients with early stage cervical cancer and to compare with traditional radical hysterectomy (CRH) to explore the clinical value of NSRH. Methods Thirty patients with early stage cervical cancer in our hospital from June 2012 to June 2014 were divided into two groups (group A and group B). The patients in group A received NSRH and the patients in group B received CRH. Each group All 15 cases were stage ⅠB ~ ⅡA1. In operation, 3 patients in group A failed to maintain autonomic nerve plane and were assigned to group B. The intraoperative status, postoperative recovery status and complications of the two groups were observed and recorded . Results There was no significant difference in operative time, blood loss, tumor size, paracancer excision length, vaginal resection length and pelvic lymphadenectasis between group A and group B (t = 1.713 and 1.381 respectively , 1.047, 2.014 3, 1.973, 1.479 2, P> 0.05). Postoperative ureteral indwelling time, postoperative spontaneous deflation time and postoperative spontaneous bowel movement were significantly shorter in group A than those in group B. The residual urine volume in group A was less than that in group B after 10 days (t = 13.287, 9.367 1, 16.727 1, 27.468, P <0.05). There was still 3 cases of urinary frequency, urinary urgency, urinary tract infection and other symptoms in group B, there were no such cases in group A after 6 months of follow-up survey. The incidence of postoperative complications in group A was significantly lower than that in group B, the difference was statistically significant (χ ~ 2 values were 1.766 2,5.477 2,0.017,0.562,8.711, P <0.05). Conclusions NSRH is safe and reliable, not only has obvious advantages compared with CRH, but also has a significant effect on improving postoperative rectal function and bladder function. It also has a significant effect on improving postoperative quality of life, and the incidence of complications after 6 months Low, with great clinical significance.