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目的探讨保留盆腔自主神经根治术(NSRH)与传统Piver-RutedgeⅢ型宫颈癌根治术(RH)治疗Ⅰb期宫颈癌的临床疗效。方法选取2011年5月至2013年5月间收治的Ⅰb期子宫颈癌患者70例,根据手术方式分为对照组与研究组。对照组患者采用RH术治疗,研究组患者采用NSRH术治疗。比较两组患者手术时间、术中出血量及术后功能恢复情况。结果对照组患者手术时间为(236.73±40.13)min,术中出血量为(512.43±124.73)ml,留置尿管时间为(21.78±5.46)d。研究组患者手术时间为(251.32±38.45)min,术中出血量为(529.11±125.69)ml,留置尿管时间为(12.15±3.24)d,两组手术时间和术中出血量间差异无统计学意义(P>0.05);对照组患者留置尿管时间明显长于研究组,差异有统计学意义(P<0.05);两组患者主韧带、骶韧带、阴道前后壁以及盆腔淋巴结切除数目差异无统计学意义(P>0.05);研究组患者术后膀胱功能与直肠功能恢复时间明显短于对照组,差异有统计学意义(P<0.05)。结论 NSRH治疗Ⅰb期宫颈癌保留了盆腔自主神经,安全性和可行性较高,并且有利于患者膀胱和直肠功能的恢复,可提高患者生活质量,值得临床广泛推广应用。
Objective To investigate the clinical efficacy of preserving pelvic autonomic nerve root (NSRH) and traditional Piver-Rutedge type Ⅲ cervical cancer (RH) in the treatment of stage Ⅰb cervical cancer. Methods Seventy patients with stage Ⅰb cervical cancer admitted to our hospital from May 2011 to May 2013 were divided into control group and study group according to the operation method. The patients in the control group were treated with RH and the study group were treated with NSRH. The operation time, intraoperative blood loss and postoperative functional recovery were compared between the two groups. Results The operation time of the control group was (236.73 ± 40.13) min, the blood loss was (512.43 ± 124.73) ml and the catheterization time was (21.78 ± 5.46) d. In the study group, the operation time was (251.32 ± 38.45) min, the blood loss was (529.11 ± 125.69) ml and the catheterization time was (12.15 ± 3.24) days. There was no statistical difference between the two groups in the operation time and intraoperative blood loss (P> 0.05). The time of indwelling catheter in control group was significantly longer than that in study group (P <0.05). There was no significant difference between the two groups in the number of primary ligament, sacral ligament, vaginal anterior and posterior wall and pelvic lymphadenectomy (P> 0.05). The recovery time of bladder function and rectal function in study group was significantly shorter than that in control group (P <0.05). Conclusion NSRH treatment of stage Ⅰb cervical cancer retains pelvic autonomic nerve, high safety and feasibility, and is conducive to the recovery of bladder and rectal function in patients with increased quality of life of patients, it is widely used in clinical practice.