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目的研究宫颈癌根治术保留盆腔自主神经(SNSRH)的临床解剖与尿潴留,观察其术后膀胱功能恢复情况。方法选择2008年8月-2009年7月,88例临床分期ⅠB1～ⅡA宫颈鳞状上皮细胞癌患者,成功实施SNSRH患者53例(保留组),未实施SNSRH患者35例(对照组)。比较两组间的总手术时间、总失血量,观察术后膀胱功能恢复情况。结果两组患者手术均顺利;①保留组总手术时间(142.33±6.510)min、总失血量(474.40±18.400)ml,与对照组(136.93±13.572)min、(467.73±12.680)ml比较,两组间差异无统计学意义(P>0.05)。②术后7d拔除尿管,测残余尿量保留组(67.27±11.817)ml,对照组(348.67±78.533)ml,两组间差异有显著统计学意义(P<0.01)。保留组留置尿管时间(7.89±0.933)d,对照组(22.89±5.150)d,两组间差异有显著统计学意义(P<0.01)。③术后病理回示:两组宫骶韧带、主韧带、均未见癌组织。结论宫颈癌SNSRH保留支配膀胱的自主神经系统,术后膀胱功能恢复快、效果满意,避免尿潴留的发生。
Objective To study the clinical anatomy and urinary retention of pelvic autonomic nerve (SNSRH) after radical hysterectomy and observe the postoperative recovery of bladder function. Methods From August 2008 to July 2009, 88 patients with ⅠB1 ~ ⅡA cervix squamous cell carcinoma were enrolled in this study. Fifty-three patients with SNSRH (reserved group) and 35 without SNSRH (control group) were successfully treated. The total operation time and total blood loss were compared between the two groups to observe the postoperative recovery of bladder function. Results The total operation time (142.33 ± 6.510) min and total blood loss (474.40 ± 18.400) ml in the retention group were significantly lower than those in the control group (136.93 ± 13.572) min and (467.73 ± 12.680) ml, respectively There was no significant difference between groups (P> 0.05). ② The catheter was removed 7 days after operation, and the residual urine volume (67.27 ± 11.817) ml and the control group (348.67 ± 78.533) ml were measured. There was significant difference between the two groups (P <0.01). The retention time of ureteral catheter (7.89 ± 0.933) d, control group (22.89 ± 5.150) d, the difference between the two groups was statistically significant (P <0.01). ③ postoperative pathology showed: two groups uterosacral ligament, the main ligament, no cancer. Conclusion Cervical cancer SNSRH retains the autonomic nervous system that controls the bladder. The postoperative recovery of bladder function is quick and the results are satisfactory and the occurrence of urinary retention can be avoided.