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目的:比较保留神经的广泛性子宫切除术(Nerve-sparing radical hysterectomy,NSRH)和传统的广泛性子宫切除术(radical hysterectomy,RH)对宫颈癌患者盆腔自主神经功能的影响以及围手术期并发症的发生情况。方法:选择2007年10月1日～2010年9月30日在宜兴市人民医院接受手术治疗的患者92例,其中接受NSRH 46例,接受RH 46例,均为Ⅰa～Ⅱb期宫颈浸润癌。观察两种手术对患者膀胱功能的影响,比较手术时间、术中出血量和围手术期并发症的发生情况。结果:术后平均尿管留置时间NSRH和RH患者分别为(11.37±3.25)天和(20.15±9.10)天,NSRH患者短于RH患者,差异有统计学意义(P<0.001)。平均手术时间、术中出血量NSRH和RH患者分别为(208.58±43.70)min和(221.30±37.79)min、(498.91±227.42)ml和(571.96±241.47)ml,两者比较差异均无统计学意义(P>0.05)。两组患者术后病理检查均未提示有阳性手术切缘,两组各有1例输尿管损伤。随访3年NSRH患者未见复发,RH患者有1例复发。结论:NSRH手术能有效保护早期宫颈浸润癌患者的盆腔自主神经功能,且安全可行。
OBJECTIVE: To compare the effects of Nerve-sparing radical hysterectomy (NSRH) and traditional radical hysterectomy (RH) on pelvic autonomic nervous system function and perioperative complications in patients with cervical cancer The occurrence of. Methods: Totally 92 patients undergoing surgery in Yixing People’s Hospital from October 1, 2007 to September 30, 2010 were enrolled. Among them, 46 patients received NSRH and 46 received RH. All of them were stage Ⅰa-Ⅱb cervical invasive carcinoma. The effects of two kinds of surgery on bladder function were observed. The operation time, intraoperative blood loss and perioperative complications were compared. Results: The mean postoperative urinary retention time in patients with NSRH and RH was (11.37 ± 3.25) days and (20.15 ± 9.10) days, respectively. There was a statistically significant difference between NSRH patients and RH patients (P <0.001). Mean operative time and blood loss in patients with NSRH and RH were (208.58 ± 43.70) min and (221.30 ± 37.79) min, (498.91 ± 227.42) ml and (571.96 ± 241.47) ml, respectively, with no statistical difference Significance (P> 0.05). Two groups of patients postoperative pathological examination did not prompt positive surgical margins, two cases each have ureteral injury. No recurrence was observed in 3 years of NSRH patients and 1 patient was relapsed in RH patients. Conclusion: NSRH can effectively protect pelvic autonomic nerve function in patients with early stage cervical invasive carcinoma and is safe and feasible.