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目的:探讨系统保留盆腔自主神经广泛子宫切除术治疗宫颈癌及子宫内膜癌的临床效果及安全性。方法:收集2013年6月至2014年6月我院收治的宫颈癌和子宫内膜癌患者82例,将其随机分为观察组与对照组,每组各41例。观察组行系统保留盆腔自主神经的广泛子宫切除术,对照组行传统根治性子宫切除术,比较两组的手术时间、术中出血量、术后拔除尿管时间、残余尿量、术后排气以及排便时间以及术中及术后并发症的发生情况。结果:两组的手术时间及术中出血量比较无明显差异(P>0.05),但观察组的术后拔管时间、尿残余量、排气及排便时间均较对照组显著缩短或降低(P<0.05)。两组的手术并发症主要包括便秘、血便、腹泻、尿路感染、尿失禁、尿频尿急,观察组并发症的总发生率较对照组显著降低(P<0.05)。结论:广泛子宫切除术中系统保留盆腔自主神经有利于保护宫颈癌及子宫内膜癌患者的膀胱和直肠功能,降低手术相关并发症,提高患者的术后康复质量与生活质量。
Objective: To investigate the clinical effect and safety of systematic preservation of pelvic autonomic nerve extensive hysterectomy in the treatment of cervical cancer and endometrial cancer. Methods: 82 cases of cervical cancer and endometrial cancer admitted to our hospital from June 2013 to June 2014 were randomly divided into observation group and control group, with 41 cases in each group. The observation group received extensive hysterectomy of pelvic autonomic nerve system. The control group underwent conventional radical hysterectomy. The operation time, intraoperative blood loss, postoperative ureteral time, residual urine volume, Gas and defecation time as well as intraoperative and postoperative complications. Results: There was no significant difference in operative time and intraoperative blood loss between the two groups (P> 0.05). However, the extubation time, residual urine volume, excretion and defecation time in the observation group were significantly shorter or lower than those in the control group P <0.05). The complications of the two groups mainly included constipation, bloody stools, diarrhea, urinary tract infection, urinary incontinence, urinary frequency and urinary urgency. The complication rates in the observation group were significantly lower than those in the control group (P <0.05). CONCLUSION: Systemic retention of pelvic autonomic nerve during extensive hysterectomy is helpful to protect the bladder and rectum of patients with cervical cancer and endometrial cancer, reduce the complications related to surgery and improve the quality of postoperative rehabilitation and quality of life.