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目的:探讨盆腔自主神经保留对早期宫颈癌患者术后排尿、排便及性功能改善的价值。方法:选择19例宫颈癌患者(临床分期Ⅰb期11例,Ⅱa期8例)施行保留盆腔自主神经的广泛性子宫切除术(NSRH),术中在处理主韧带、宫骶韧带、深层膀胱宫颈韧带及阴道旁组织时保留盆腔内脏神经、腹下神经、下腹下神经丛及其膀胱分支。结果:平均手术时间为195 min,平均失血量290 ml,所有病例术后48～72 h恢复肛门排气;术后4～7天拔除导尿管,残余尿量均<100 ml;平均住院时间为10.5天,出院时均能自主排尿,无便秘或排便时间延长等不适。随访6个月,性生活满意者6例,性生活一般者5例,无性生活者8例。结论:早期宫颈癌患者施行NSRH手术是可行的,它可以改善患者的排尿、排便及性功能,提高患者的术后生存质量。
Objective: To investigate the value of preserving pelvic autonomic nerve on postoperative urination, defecation and sexual function in patients with early cervical cancer. Methods: Nineteen patients with cervical cancer (11 in clinical stage Ⅰb and 8 in stage Ⅱa) underwent radical hysterectomy (NSRH) with preserving pelvic autonomic nervous system. In the treatment of primary ligament, uterosacral ligament and deep bladder cervix Ligament and vaginal tissues remain pelvic visceral nerve, hypogastric nerve, inferior epigastric nerve plexus and bladder branch. Results: The average operation time was 195 min and the average blood loss was 290 ml. The anal exhaust was recovered 48-72 h postoperatively. The catheter was removed 4 to 7 days after operation. The residual urine volume was less than 100 ml. The mean hospital stay 10.5 days, discharged spontaneously without urination, no constipation or bowel movements extended discomfort. Follow-up 6 months, 6 were satisfied with sexual life, 5 were generally sexually active, 8 were asexual life. Conclusion: It is feasible to use NSRH in early cervical cancer patients. It can improve urination, defecation and sexual function of patients and improve postoperative quality of life.