腹腔镜下保留盆腔神经广泛子宫切除对宫颈癌患者术后膀胱功能、性功能及血清Leptin、Hcy的影响
Influence of laparoscopic nerve-sparing radical hysterectomy on postoperative bladder function,sexual function,serum leptin and Hcy in cervical cancer patients
李雯慧 1方诚 2闫枫尚 1徐明娟1
作者信息
- 1. 海军军医大学第一附属医院妇产科,上海 200433
- 2. 海军军医大学第三附属医院肝外四科,上海 200433
- 折叠
摘要
目的:探讨腹腔镜下保留盆腔神经广泛子宫切除术(LNSRH)对宫颈癌患者术后膀胱功能、性功能及血清瘦素(Leptin)、同型半胱氨酸(Hcy)水平的影响.方法:回顾性收集2020年11月至2022年11月期间本院收治的220例宫颈癌患者临床资料,根据手术方法不同分为对照组(n=110)和观察组(n=110),对照组实施腹腔镜下广泛子宫切除术(LRH),观察组实施LNSRH,比较两组患者手术情况、术后恢复情况、术后膀胱功能,以及性功能、血清Leptin、Hcy水平,统计两组患者术后生存情况.结果:观察组手术时间较对照组更长,术后住院时间短于对照组,两组术中出血量、阴道切除长度对比未见明显差异;两组尿失禁、尿潴留发生率对比无显著性差异,观察组拔尿管时间、膀胱功能障碍发生率、腹压排尿发生率明显优于对照组;术后,两组患者血清Leptin、Hcy水平较术前均下降,且观察组低于对照组;观察组术后性欲望、性唤起及性高潮、阴道润滑及性交痛、性生活满意度评分高于对照组;两组患者术后均未出现死亡病例,观察组复发率(2.73%)略低于对照组(6.36%),但未见显著性差异.结论:LNSRH术可促进宫颈癌患者术后恢复,改善术后膀胱功能及性功能,有效降低血清Leptin、Hcy水平,且术后安全性良好.
Abstract
Objective To investigate the influence of laparoscopic nerve-sparing radical hysterectomy(LNSRH)on postop-erative bladder function,sexual function,serum leptin and homocysteine(Hcy)levels in patients with cervical cancer.Methods The clinical data of 220 cervical cancer patients who were admitted to the hospital between November 2020 and November 2022 were collected retrospectively.According to different surgical methods,the patients were divided into the control group(n=110)and observation group(n=110).The control group was treated with laparoscopic radical hysterectomy(LRH),while the observation group was treated with LNSRH.Surgical conditions,postoperative recovery,postoperative bladder function,sexual function,serum leptin and Hcy levels,and postoperative survival of the two groups were comparatively analyzed.Results Surgical time of the observation group was longer than that of the control group,and postoperative hospital stay was shorter than that of the control group.There was no significant difference between the two groups in terms of intraoperative blood loss,the length of vagina removed,the incidence of urinary incontinence,and the incidence of urinary retention.The time of catheter removal,and the incidence rates of bladder dysfunction and urination with abdominal pressure in the observation group were significantly better than those in the control group.After operation,serum leptin and Hcy levels in the two groups were lower than those before surgery.Meanwhile,serum leptin and Hcy levels in the observation group were lower than those in the control group.After operation,the scores for sexual desire,sexual arousal and orgasm,vaginal lubrication and dyspareunia,and satis-faction with sexual life in the observation group were higher than those in the control group.No death case was found in either group.The recurrence rates in the observation group and the control group were 2.73%and 6.36%,without significant differ-ence.Conclusion LNSRH can promote postoperative recovery of cervical cancer patients,improve their postoperative bladder function and sexual function,and effectively reduce serum leptin and Hcy levels,with good safety.
关键词
宫颈癌/腹腔镜下保留盆腔神经广泛子宫切除术/膀胱功能/性功能/血清瘦素/同型半胱氨酸Key words
cervical cancer/laparoscopic nerve-sparing radical hysterectomy/bladder function/sexual function/serum leptin/homocysteine引用本文复制引用
基金项目
国家自然科学基金资助项目(31900566)
出版年
2024
NETL
NSTL
万方数据