本文選題：SNSRH　切入點：RH　出處：《延安大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過比較SNSRH與RH患者術(shù)前、術(shù)中、術(shù)后相關(guān)指標(biāo),探討SNSRH術(shù)式臨床應(yīng)用的安全性、可行性、有效性以及對保留盆腔自主神經(jīng)的意義和改善術(shù)后膀胱功能的作用,從而為臨床提供可靠的理論依據(jù),達(dá)到降低患者術(shù)后并發(fā)癥及提高其生存質(zhì)量的目的。方法:選取2015年1月至2017年2月期間就治于延安大學(xué)附屬醫(yī)院婦科病區(qū)的宮頸癌患者60例作為前瞻性研究對象,分為SNSRH組和RH組,SNSRH組30例符合并且行SNSRH手術(shù),RH組30例行常規(guī)RH手術(shù)。對比分析兩組患者的平均出血量、平均手術(shù)時間、切除子宮主韌帶、骶韌帶及陰道前、后壁長度、再次留置尿管次數(shù)、切緣病理情況、切除子宮主、骶和膀胱宮頸韌帶切緣神經(jīng)分布狀態(tài)以及術(shù)前、術(shù)后尿動力學(xué)檢查相關(guān)參數(shù)。所有入選研究指標(biāo)都使用Microsoft Excel軟件建立數(shù)據(jù)庫并且應(yīng)用SPSS 22.0軟件包進(jìn)行統(tǒng)計學(xué)分析。結(jié)果:1.SNSRH組與RH組平均手術(shù)時間比較,差異有統(tǒng)計學(xué)意義(P0.05)。SNSRH組與RH組術(shù)中平均出血量、切除子宮主韌帶、骶韌帶及陰道前、后壁長度、切緣病理情況方面,差異均無統(tǒng)計學(xué)意義(P0.05)。2.SNSRH組與RH組在切除子宮主、骶和膀胱宮頸韌帶切緣神經(jīng)分布狀態(tài)方面對比分析,差異具有統(tǒng)計學(xué)意義(P0.05)。3.SNSRH組與RH組在再次留置尿管次數(shù)及術(shù)前、術(shù)后尿動力學(xué)檢查相關(guān)參數(shù)方面比較,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:1.SNSRH較RH切除子宮主、骶及膀胱宮頸韌帶切緣的神經(jīng)分布明顯減少,說明SNSRH術(shù)中對于PAN的損傷小,達(dá)到保留PAN的目的。2.SNSRH和RH術(shù)后均導(dǎo)致膀胱功能發(fā)生不同程度的功能障礙,但是SNSRH較RH導(dǎo)致膀胱功能障礙的程度明顯減輕。3.SNSRH不僅手術(shù)范圍廣,而且具有安全、可行、短期療效好的特點。
[Abstract]:Objective: to study the safety, feasibility, effectiveness and significance of SNSRH and RH in preserving pelvic autonomic nerve and improving bladder function after operation by comparing the relevant indexes before, during, and after operation in patients with SNSRH and RH, and to explore the safety, feasibility and effectiveness of the clinical application of SNSRH. Thus providing a reliable theoretical basis for clinical practice, Methods: from January 2015 to February 2017, 60 patients with cervical cancer treated in gynecological ward of affiliated Hospital of Yan'an University were selected as prospective subjects. SNSRH group and RH group were divided into SNSRH group and RH group (n = 30). The average bleeding volume, mean operative time, the length of the main uterine ligament, sacral ligament and anterior and posterior wall of vagina were compared and analyzed in RH group and RH group. The number of re-indwelling urethral tubes, the pathological condition of the incisal margin, the distribution of the incised edge nerves of the hysterectomy, sacral and bladder cervical ligaments, and the preoperation, Microsoft Excel software was used to establish the database and SPSS 22.0 software package was used for statistical analysis. Results 1. The mean operation time of SNSRH group was compared with that of RH group. There was no significant difference in the mean blood loss, the length of the anterior and posterior wall of the uterus, sacral ligament and vagina, and the pathological condition of the incision margin between the SNSRH group and the RH group. 2. There was no significant difference between the SNSRH group and the RH group in the hysterectomy. There were significant differences in the distribution of nerves between sacral and bladder cervical ligament incised margin. 3. SNSRH group and RH group were compared in the frequency of re-indwelling urethral catheter and the relative parameters of urodynamic examination before and after operation. Conclusion: 1. The nerve distribution of sacral and bladder cervical ligament incised by RH is significantly reduced than that of RH, indicating that the injury to PAN in SNSRH is less than that in RH. 2. Both SNSRH and RH resulted in different degree of bladder dysfunction after operation. However, the degree of bladder dysfunction caused by SNSRH was significantly reduced than that of RH. 3. SNSRH not only had a wide range of operation, but also was safe and feasible. The characteristic of good short-term curative effect.
【學(xué)位授予單位】：延安大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R737.33

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