本文選題：腹腔鏡 + 保留神經(jīng)��； 參考：《第三軍醫(yī)大學(xué)學(xué)報(bào)》2017年07期

【摘要】：目的分析比較腹腔鏡下保留盆腔自主神經(jīng)廣泛性子宮切除術(shù)(laparoscopic nervesparing radical hysterectomy,LNSRH)及傳統(tǒng)腹腔鏡下廣泛性子宮切除術(shù)(laparoscopic radical hysterectomy,LRH)兩種術(shù)式宮頸癌患者術(shù)后盆底功能恢復(fù)情況,探討LNSRH對(duì)患者盆底功能的影響。方法收集2012-2014年FIGO臨床分期為Ⅰb1~Ⅱa2期、于我院接受LNSRH(觀察組,n=138)和LRH(對(duì)照組,n=138)的宮頸癌患者的臨床資料,進(jìn)行回顧性隊(duì)列研究,比較兩組患者的手術(shù)時(shí)間、術(shù)中出血量、淋巴結(jié)切除數(shù)目、陰道壁切除長(zhǎng)度、住院時(shí)間和并發(fā)癥情況,觀察兩種手術(shù)對(duì)患者術(shù)后膀胱、直腸及生活質(zhì)量的影響。結(jié)果患者均順利完成手術(shù),兩組患者的手術(shù)時(shí)間、術(shù)中出血量、淋巴結(jié)切除數(shù)目、陰道壁切除長(zhǎng)度、死亡率及復(fù)發(fā)率比較差異均無統(tǒng)計(jì)學(xué)意義(P0.05);與LRH組比較,LNSRH組術(shù)后住院時(shí)間、肛門排氣時(shí)間及排便時(shí)間均縮短,術(shù)后泌尿系統(tǒng)并發(fā)癥(34.8%vs 71.0%)及消化系統(tǒng)并發(fā)癥(21.7%vs 49.3%)均減少,差異有統(tǒng)計(jì)學(xué)意義(P0.05);LNSRH組留置尿管天數(shù)主要集中在7~14 d,而LRH組主要集中在15 d,差異有統(tǒng)計(jì)學(xué)意義(P0.05);LNSRH組術(shù)后尿失禁生活質(zhì)量問卷(incontinence quality of life questionnaire,I-QOL)及盆底障礙影響簡(jiǎn)易問卷7(pelvic floor impact questionnaire 7,PFIQ-7)評(píng)分均優(yōu)于LRH組(P0.05)。結(jié)論 LNSRH作為早期宮頸癌手術(shù)治療方式,可保護(hù)患者術(shù)后膀胱、直腸等盆底器官功能,并在一定程度上提高患者術(shù)后生活質(zhì)量。
[Abstract]:Objective to analyze and compare the pelvic floor function recovery of two kinds of cervical cancer patients with laparoscopic radical hysterectomy (laparoscopic nervesparing radical hysterectomy, LNSRH) and conventional laparoscopic extensive hysterectomy (laparoscopic radical hysterectomy, LRH), and to explore the effect of LNSRH on the pelvic floor. Methods the effect of bottom function. Methods the clinical data of 2012-2014 years FIGO clinical stage I b1~ II A2 were collected, and the clinical data of the patients with cervical cancer in our hospital received LNSRH (observation group, n=138) and LRH (control group, n=138) were reviewed. The operative time, the amount of intraoperative bleeding, the number of lymph node excision, the length of vaginal wall excision, the length of the vaginal wall resection, and the hospitalization were compared. The effects of two kinds of operation on bladder, rectum and quality of life after operation were observed. The results were all successfully completed. There was no significant difference in the time of operation, the amount of bleeding, the number of lymph nodes, the length of the vaginal wall, the mortality and the recurrence rate of the two groups (P0.05), and compared with the group LRH, LNS In group RH, the time of hospitalization, the time of anus exhaust and the time of defecation were shortened. The postoperative urinary system complications (34.8%vs 71%) and the digestive system complications (21.7%vs 49.3%) were reduced, the difference was statistically significant (P0.05); the number of indwelling catheter days in group LNSRH was mainly concentrated in 7~14 D, while LRH group was mainly concentrated in 15 d, and the difference was statistically significant (P0.05). The quality of life questionnaire (incontinence quality of life questionnaire, I-QOL) and pelvic floor disorder after operation in group LNSRH were superior to that of simple questionnaire 7 (pelvic floor impact questionnaire 7, PFIQ-7). Function and improve the quality of life of patients to a certain extent.

【作者單位】： 第三軍醫(yī)大學(xué)西南醫(yī)院婦產(chǎn)科;
【分類號(hào)】：R713;R737.33

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本文編號(hào)：1779067