25例宫颈癌保留自主神经功能手术对性功能影响的临床研究

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[目的]探讨宫颈癌保留自主神经功能的子宫广泛切除及盆腔淋巴结清扫术对性功能的影响。[方法]49例宫颈癌患者随机分为保留自主神经功能的子宫广泛切除及盆腔淋巴结清扫术(NSRH术)组(25例,NSRH组)和传统子宫广泛切除及盆腔淋巴结清扫术(传统RH术)组(24例,RH组)。使用女性性功能量表(Fs Fx)对两组患者术前术后性功能状况进行评定。分析患者行保留自主神经功能的子宫广泛切除及盆腔淋巴结清扫术对性功能的影响。[结果 ]两组患者术前指标无显著差异,NSRH组术后腰腹痛、排便异常发生率低于RH组,差异有统计学意义(P<0.05)。NSRH组患者术前术后性欲望、性唤起及高潮、阴道润滑及性交痛、性满意度4项比较无显著性差异,总体性功能评分术前(80.62±18.21)、术后(75.22±17.96)差异无统计学意义(P>0.05)。而RH组患者术后(62.13±15.54)总体性功能评分明显低于术前(79.40±16.26),差异具有统计学意义(P<0.05)。组间比较:术后两组患者性欲望和性满意度比较无显著性差异(P>0.05);但在性唤起及高潮、阴道润滑及性交痛、总体性功能评分上RH组显著低于NSRH组(P<0.05)。[结论]保留自主神经功能的子宫广泛切除及盆腔淋巴结清扫术对女性性欲望及满意度上无明显影响,但对性唤起及高潮、阴道润滑及性交痛等性生活质量上有明显改善,值得在临床上推广。 [Objective] To investigate the effect of extensive uterine excision and pelvic lymphadenectomy on the maintenance of cervical function in patients with cervical cancer. [Methods] Forty-nine patients with cervical cancer were randomly divided into two groups: extensive uterine resection with reserved autonomic nerve function and radical resection of pelvic lymph node dissection (NSRH group) (25 cases, NSRH group) and conventional hysterectomy and pelvic lymphadenectomy ) Group (24 cases, RH group). The preoperative and postoperative functional status of the two groups was assessed using the Female Sexual Function Scale (Fs Fx). Analysis of patients with reserved autonomic function of the uterus wide excision and pelvic lymph node dissection on sexual function. [Results] There was no significant difference in preoperative indexes between the two groups. The incidence of postoperative abdominal pain and defecation in NSRH group was lower than that in RH group (P <0.05). There were no significant differences in sexual desire, sexual arousal and orgasm, vaginal lubrication and sexual intercourse pain and sexual satisfaction in NSRH group before operation. There was no significant difference in the total sexual function score between preoperative and postoperative (80.62 ± 18.21) and postoperative (75.22 ± 17.96 ) Difference was not statistically significant (P> 0.05). However, the overall functional score of the RH group after operation (62.13 ± 15.54) was significantly lower than that of the preoperative (79.40 ± 16.26), the difference was statistically significant (P <0.05). There were no significant differences in sexual desire and sexual satisfaction between the two groups after operation (P> 0.05). However, the scores of sexual arousal and climax, vaginal lubrication and sexual intercourse pain and general sexual function score in RH group were significantly lower than those in NSRH Group (P <0.05). [Conclusion] The extensive uterine resection and pelvic lymphadenectomy with autonomic nerve function have no significant effect on female sexual desire and satisfaction, but there is a significant improvement on sex life such as sexual arousal, orgasm, vaginal lubrication and sexual intercourse pain, which is worth In the clinical promotion.
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