改良与传统阴式子宫切除术治疗更年期中重度子宫脱垂效果及对患者尿动力学及生活质量的影响

Effect of the modified and thetraditional vaginal hysterectomy for treating menopausal patients with moderate-to-severe uterine prolapse and their influence on the urodynamics and quality of life

目的:对比改良与传统阴式子宫切除术治疗更年期中重度子宫脱垂效果及对患者尿动力学及生活质量的改善情况。方法:选取本院2020年10月-2023年12月收治的更年期中重度子宫脱垂患者85例,依据手术方式分组,行改良阴式子宫切除术患者43例为观察组,行传统阴式子宫切除术患者42例为对照组。观察两组手术治疗的临床疗效,对比治疗前后尿动力学指标、盆底功能指标,评价两组治疗的安全性及生活质量变化。结果:观察组临床疗效(93.0%)高于对照组(71.4%),术后1个月观察组最大尿道闭合压(34.12±1.58 cmH_(2)O)、最大尿道压(53.28±4.39 cmH_(2)O)、腹压漏尿点压(84.98±3.15 cmH_(2)O)均高于对照组(32.56±2.17 cmH_(2)O、50.37±5.31 cmH_(2)O、81.36±4.34cmH_(2)O),术后1个月时的盆底功能障碍改善效果优于对照组,术后3个月的生活质量简表中各维度评分均高于对照组(均P<0.05);两组术后并发症发生率(4.6%、7.1%)无差异(P>0.05)。结论:相比于传统阴式子宫切除术,改良阴式子宫切除术对更年期中重度子宫脱垂治疗效果更佳,对尿动力学指标及生活质量的改善更明显。

Objective:To compare the influence of the modified and the traditional vaginal hysterectomy for treating menopausal patients with moderate-to-severe uterine prolapse,and to study their influence on the urodynamics and quality of life of the patients.Methods:85 menopausal patients with moderate to-severe uterine prolapse in the hospital were selected and were divided into two groups according to the surgical methods from October 2020 to December 2023.43 patients in observation group were given the modified vaginal hysterectomy,and 42 patients in control group were given the traditional vaginal hysterectomy.The clinical efficacy of the patients in the two groups was observed.The values of the urodynamic indexes and the pelvic floor function indexes of the patients before and after treatment were compared between the two groups.The safety and quality of life of the patients in two groups were evaluated.Re-sults:The clinical efficacy of the patients in the observation group was 93.0%,which was significantly higher than that(71.4%)of the patients in the control group.The values of the maximum urethral closure pressure(34.12±1.58 cmH_(2)O),the maximum urethral pressure(53.28±4.39 cmH_(2)O)and the abdominal leak point pressure(84.98±3.15 cmHzO)of the patients in the observation group in 1 month after surgery were significantly higher than those(32.56±2.17 cmH_(2)O,50.37±5.31 cmH_(2)O and 81.36±4.34cmH_(2)O)of the patients in the control group.The improved effect of the pelvic floor dysfunction of the patients in the observation group in 1 month after surgery was significantly higher than that of the patients in the control group.The scores of the each dimension of short form quality of life scale(SF-36)of the patients in the observation group in 3 months after surgery was significantly higher than that of the patients in the control group(all P<0.05).The incidence of the postoperative complications(4.6%vs.7.1%)of the patients in the two groups had no significantly different between the two groups(P>0.05).Conclusion:Compared with that of the traditional vaginal hysterectomy,the modified vaginal hysterectomy for treating the menopausal patients with mod-erate-to-severe uterine prolapse has more effective,and the improvements of which for the urodynamic indexes and the quality of life of the patients are more obvious.