保留盆腔自主神经的根治性子宫切除对术后肛门直肠功能的影响

曹晓霞

（陕西省榆林市中医院北方医院妇产科，陕西 榆林，719000）

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摘要：

目的 观察保留盆腔自主神经的根治性子宫切除对宫颈癌术后肛门直肠功能的影响。方法 选取我院2012年2月至2016年2月收治的64例宫颈癌患者，随机分为对照组和观察组，每组32例。对照组采用根治性子宫切除术治疗，观察组采用保留盆腔自主神经的根治性子宫切除术治疗。比较两组患者手术情况、尿流动力学指标和术后直肠肛管测压。结果 观察组手术时间明显长于对照组（P<0.05）；观察组排尿次数、残余尿量、出现初始尿意膀胱容量、强烈尿意膀胱容量显著少于对照组，最大排尿量显著大于对照组（P<0.05）；观察组肛管最大缩榨压高于对照组，初始感觉阈值于对照组（P<0.05）。结论 保留盆腔自主神经的根治性子宫切除对患者肛门直肠功能影响较小，利于患者术后康复，值得临床推广应用。

关键词：自主神经；根治性子宫切除；肛门直肠；宫颈癌

中图分类号：R737.33 文献标志码：A文章编号：2096-1413(2017)32-0093-02

Effect of pelvic autonomic nerve-sparing radical hysterectomy on postoperative anorectal function
CAO Xiao-xia
(Department of Obstetrics and Gynecology, Beifang Hospitl, Yulin Hospital of Traditional Chinese Medicine, Yulin 719000, China)

ABSTRACT: Objective To observe the effect of pelvic autonomic nerve -sparing radical hysterectomy on postoperative anorectal function in cervical cancer. Methods Sixty -four patients with cervical cancer admitted in our hospital from February 2012 to February 2016 were randomly divided into control group and observation group, with 32 cases in each group. The control group was treated with radical hysterectomy and the observation group was treated with pelvic autonomic nerve -sparing radical hysterectomy. The surgical conditions, urodynamic indicators and postoperative rectal anal canal pressure measurement were compared between the two groups. Results The operation time of the observation group was longer than that of the control group (P<0.05). The urinary frequency, the residual urine volume, the bladder capacity of initial micturition desire and strong micturition desire in the observation group were significantly lower, and the maximum amount of urine output was higher than those in the control group (P<0.05). The maximal compression pressure of the anal canal was higher than that of the control group, and the initial sensory threshold in the observation group was lower than that in the control group (P<0.05). Conclusion The pelvic autonomic nerve-sparing radical hysterectomy has less effect on anorectal function and is conducive to postoperative rehabilitation, which is worthy of clinical application.
KEYWORDS: autonomic nerve; radical hysterectomy; anorectal; cervical cancer

参考文献：
[1] 于月成,吴维光,谢婷婷.系统保留盆腔自主神经的宫颈癌广泛性子宫切除术对膀胱功能的影响[J].现代肿瘤医学,2012,20(1):142-144.
[2] 王艳红.经腹腔镜保留盆腔自主神经根治性子宫切除术治疗早期 宫颈癌的疗效[J].肿瘤基础与临床,2014,27(2):129-131.
[3] 靖丽华.宫颈癌广泛性子宫切除术中系统保留盆腔自主神经的临 床效果分析[J].中国实用医药,2015,10(3):104-105.
[4] 王娟,罗明达,董潇楠,等.保留盆腔自主神经的根治性子宫切除术 患者术后肛门直肠功能观察[J].山东医药,2016,56(43):88-90.
[5] 朱前勇,郭伟平,申沛,等.腹腔镜下系统保留盆腔自主神经的广泛性 子宫切除术治疗早期宫颈癌38 例[J].重庆医学,2011,40(21):2128-2130.
[6] 齐周芳,徐惠成,姚宏,等.系统保留盆腔自主神经的广泛子宫切除 术治疗宫颈癌及子宫内膜癌的临床效果分析[J].现代生物医学进展,2015,15(22):4337-4340.
[7] 杨海坤,魏伟峰,曾小倩,等.腹腔镜下保留盆腔自主神经广泛性子 宫切除术治疗早期宫颈癌疗效和安全性研究[J].中国医药科学,2014,4(5):67-69.
[8] 陈龙,张盛苗,张萍.腹腔镜下保留盆腔自主神经的广泛子宫切除 术治疗早期宫颈癌临床价值探讨[J].中国实用妇科与产科杂志,2013,29(8):645-648.