摘要
目的探讨腹腔镜下保留盆腔自主神经的广泛性子宫切除术(LNSRH)治疗老年早期宫颈癌患者的临床疗效。方法入组70例老年早期宫颈癌患者,采取信封法随机均分为2组,分别接受LNSRH手术加盆腔淋巴结清扫术(观察组)和腹腔镜下广泛性子宫切除术(LRH)加盆腔淋巴结清扫术(对照组),并比较观察2组患者的围手术期情况、并发症情况、术后膀胱功能、术后肛门直肠功能。结果观察组的手术时间为(275.32±67.28)min,长于对照组的(197.66±47.14)min(P<0.05)。观察组留置尿管时间、术后排气时间、术后排便时间分别为(9.73±3.82)d、(63.24±23.61)h、(90.25±31.74)h,均短于对照组的(16.27±5.91)d、(83.78±32.10)h、(123.10±38.69)h(P<0.05)。2组术中出血量、术后并发症发生率、主韧带切除长度、骶韧带切除长度、阴道壁切除长度、淋巴结切除数目比较差异均无统计学意义(P均>0.05)。观察组泌尿系统症状、消化系统症状发生率分别为11.43%、22.86%,明显低于对照组的65.71%、45.71%(P均<0.05)。结论 LNSRH治疗老年早期宫颈癌是安全可靠的,比LRH更快恢复膀胱功能以及肛门和(或)直肠功能,泌尿系统、消化系统症状更少。
Objective To investigate the efficacy of laparoscopic nerve-sparing radical hysterectomy(LNSRH) in the treatment of elderly patients with early cervical cancer.Methods All the 70 elderly patients with early cervical cancer were randomized by envelope technique to the observation group(35 patients) or the control group(35 patients),and the perioperative index,complications,postoperative bladder function,postoperative anorectal function were compared between the two groups.Results The operation time in the observation group [(275.32 ±67.28) min] were longer than that in the control group [(197.66±47.14) min,P<0.05].The catheterization time,exhaust time and defecation time in the observation group [(9.73±3.82) d,(63.24±23.61) h,(90.25 ±31.74) h] were shorter than those in the control group [(16.27±5.91) d,(83.78±32.10) h,(123.10 ±38.69) h;P<0.05].There were no statistical differences in the intraoperative blood loss,postoperative complication rate,length of main ligament,length of sacral ligament,length of vaginal wall and number of removed lymph nodes between the two groups(P>0.05).The incidence rate of symptoms of urinary tract and digestive system in the observation group(11.43% and 22.86%) were significantly lower than those in the control group(65.71%and 45.71%,P<0.05).Conclusion Compared with LRH,LNSRH is safe and effect in the treatment of elderly patients with early cervical cancer,and the bladder and anorectal functions recover faster.
出处
《肿瘤基础与临床》
2017年第5期410-413,共4页
journal of basic and clinical oncology
基金
河南省医学科技攻关计划项目(编号:201702092)
关键词
早期宫颈癌
腹腔镜
保留神经
老年患者
early cervical cancer
laparoscope
nerve preservation
elderly patients
