摘要
目的:观察子宫颈癌患者在子宫颈癌根治术中行改良盆腔腹膜缝合法后阴道长度及性生活质量情况。方法:选择2011年1月至2017年3月在郑州大学第一附属医院行腹腔镜下子宫颈癌根治术的92例早期子宫颈鳞癌(ⅠB1～ⅡA期)患者为研究对象,按照年龄分为2组,对≤40岁的患者为年轻组(42例),而>40岁则为年长组(50例)。年轻组行卵巢移位术,年长组切除双侧附件,其中2014年之前患者子宫颈癌根治术中行传统盆腔腹膜缝合法(对照组),2014年之后至2017年3月行改良盆腔腹膜缝合法(观察组)。用回顾性分析方法调查年轻组与年长组各自观察组与对照组术中及术后情况。且在治疗结束后,通过门诊复查及电话随访的方式记录患者术后不同时间点(术后3、6、12月)阴道长度及评估患者术后12月的性生活质量。结果:年轻组与年长组各自的观察组与对照组在手术时间、术中出血量、肛门排气时间、留置导尿管时间及盆腔淋巴囊肿发生率方面差异均无统计学意义(P>0.05);年轻组与年长组术后3、6、12月时观察组阴道长度均高于对照组(P<0.05);术后12月时年轻组及年长组各自观察组均在性满意、性疼痛、性高潮方面优于对照组(P<0.05),而在性润滑、性渴望、性唤起方面差异无统计学意义(P>0.05)。结论:子宫颈癌根治术中采用改良盆腔腹膜缝合法,不显著延长手术时间、增加术中出血量、肛门排气时间、留置导尿管时间及盆腔淋巴囊肿发生率,却可明显加深阴道长度和改善患者术后性生活质量。
Objective:To observe the vaginal length and sexual quality of patients with cervical cancer after radical cervical cancer surgery with modified pelvic peritoneal suture.Methods:From January 2011 to March 2017,92 patients with early stage(ⅠB1-ⅡA) cervical squamous cell carcinoma undergoing laparoscopic radical surgery in the first affiliated hospital of Zhengzhou university were enrolled in this study.They were divided into two groups by age.Patients less than or equal to 40 years old were enrolled in the younger group,while patients more than 40 years old were included in the older group.Ovarian transposition was performed in the younger group and bilateral ovaries were removed in the older group.Traditional pelvic peritoneal suture was performed during radical cervical cancer resection before 2014(control group).Improved pelvic peritoneal suture was performed from 2014 to March 2017(observation group).Retrospective analysis was performed to investigate the intraoperative and postoperative conditions of the control and observation group in both younger and older group,respectively.Postoperative vaginal length after 3,6,12 months of surgery and sexual quality after 12 months of surgery were recorded by outpatient review and telephone follow-up.Results:There was no statistically significant difference betweent the observation group and the control group in operation time,intraoperative blood loss,anal exhaust time,indwelling urethral catheter time and incidence of pelvic lymphocyst of the younger group and the older group(P>0.05).The vaginal length of the observation group was longer than that of the control group at different time points(3,6 and 12 months after surgery) in both younger and older group(P<0.05).The observation group in both the younger group and the older group were superior to the control group in terms of sexual satisfaction,sexual pain and orgasm(P<0.05),while there was no difference in sexual lubrication,sexual desire and sexual arousal(P>0.05).Conclusions:The modified pelvic peritoneal suture method in the radical resection of cervical cancer does not significantly prolong the operation time,increase the intraoperative blood loss,anal exhaust time,indwelling urethral catheter time or the incidence of pelvic lymphocyst.However,the procedure could significantly improve the vaginal length and the postoperative sexual quality of patients.
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