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目的探讨腹腔镜下保留盆腔神经的宫颈癌根治术(LNSRH)对患者膀胱功能及短期肿瘤治疗的临床意义及该术式适用人群。方法 2013年7月至2015年11月上海交通大学医学院附属仁济医院收治的宫颈癌患者219例,150例行LNSRH术,69例行腹腔镜下宫颈癌根治术(LRH),组间比较围手术期一般情况及留置导尿管时间,组内比较尿动力学检查及膀胱自我感觉等指标。结果 LNSRH组手术时间短于LRH组[(153±42)min vs.(210±92)min,P<0.05],余围手术期一般情况未发现明显差异;LNSRH组术后留置导尿管时间短于LRH组(14 d vs.20 d,P=0.006);LNSRH组患者在术后最大尿流率、残余尿量、初始尿意膀胱容量、最大尿意膀胱容量及逼尿肌收缩等尿动力学方面恢复均优于LRH组;LNSRH组患者在术后膀胱自我感觉指标达到术前水平的时间均短于LRH组。结论 LNSRH对膀胱功能影响较小且术后膀胱功能恢复较快。
Objective To investigate the clinical significance of laparoscopic radical neoplasm of cervical cancer (LNSRH) for the treatment of bladder function and short-term tumor in patients undergoing laparoscopic surgery. Methods 219 patients with cervical cancer admitted from Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine between July 2013 and November 2015 were enrolled in the study. LNSRH was performed in 150 cases and laparoscopic radical hysterectomy (LRH) in 69 cases. Perioperative general situation and indwelling catheter time, urodynamic group comparison and bladder self-feeling and other indicators. Results The operative time in LNSRH group was shorter than that in LRH group [(153 ± 42) min vs. (210 ± 92) min, P <0.05] Shorter than LRH group (14 d vs. 20 d, P = 0.006). The urinary kinetics such as maximal urinary flow rate, residual urine volume, initial urinary bladder capacity, maximal urinary bladder capacity and detrusor contraction in patients with LNSRH The resuscitation was better than the LRH group; LNSRH group patients in the postoperative bladder self-perception index reached preoperative levels were shorter than the LRH group. Conclusions LNSRH has less effect on bladder function and faster bladder function recovery after operation.