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目的探讨保留盆腔植物神经的广泛性子宫切除术治疗宫颈癌的可行性,并评估其改善术后膀胱功能的效果。方法选取2012年2月-2013年2月该院临床分期为Ⅰb1~Ⅱa期的宫颈癌患者40例,随机分为对照组和研究组,每组各20例。对照组采用常规广泛性子宫切除手术治疗,研究组采用保留盆腔自主植物神经的广泛性子宫切除术治疗。观察两组患者术中出血量、平均手术时间以及术后并发症的发生率。结果两组术中出血量和手术时间比较,差异无统计学意义(P>0.05)。术后第8天,研究组残余尿量<100 ml比例和留置尿管时间与对照组比较,差异有统计学意义(P<0.05)。两组患者均无严重的手术相关性损伤及病理切缘不净情况发生。结论保留盆腔自主植物神经的广泛性子宫切除术治疗Ⅰb1~Ⅱa的子宫颈癌安全、可行,可明显改善患者术后膀胱功能,使用百克钳、新安速刀可使手术可操作性更强。
OBJECTIVE: To investigate the feasibility of extensive hysterectomy for pelvic autonomic nerve preservation for cervical cancer and to evaluate its effect on postoperative bladder function. Methods From February 2012 to February 2013, 40 patients with cervical cancer with clinical stage Ⅰb1 ~ Ⅱa were randomly divided into control group and study group, with 20 cases in each group. The control group was treated by conventional extensive hysterectomy. The study group was treated by extensive hysterectomy that retained pelvic autonomic autonomic nerve. The blood loss, the average operation time and the incidence of postoperative complications in two groups were observed. Results There was no significant difference in bleeding volume and operation time between the two groups (P> 0.05). On the 8th day after operation, the residual urine volume <100 ml and indwelling catheter time in the study group were significantly different from those in the control group (P <0.05). Two groups of patients were no serious surgical-related injuries and pathological margin of non-net situation occurred. Conclusions The extensive hysterectomy, which preserves pelvic autonomic nerve, is safe and feasible for the treatment of Ⅰb1 - Ⅱa cervical cancer. It can significantly improve the postoperative bladder function. The use of 100 克ps and Xin’an speed knife can make the operation more feasible.