全子宫和次全子宫切除术对子宫肌瘤患者盆底功能及生活质量的影响

Clinical effects of total and subtotal hysterectomy on the pelvic floor function and quality of life

目的:探讨全子宫与次全子宫切除术对患者盆底功能和生活质量的影响。方法:选择我院子宫切除手术治疗的子宫肌瘤患者130例采用随机数字表法分为观察组和对照组,对照组给予全子宫切除,观察组采用次全子宫切除,记录两组治疗情况。结果:观察组手术时间(70.83±10.31)min,术中出血量(108.74±14.58)m L,术后肛门排气时间(1.13±0.31)d,住院时间(5.66±1.11)d;对照组手术时间(92.38±16.37)min,术中出血量(142.97±27.15)m L,术后肛门排气时间(1.87±0.94)d,住院时间(8.96±2.24)d,组间对比差异具有统计学意义(P<0.05)。观察组性欲(188.37±17.32)分,性唤起(180.45±19.94)分,性高潮(176.98±19.13)分,性心理(178.85±17.69)分,性行为(140.28±12.77)分,综合评分(176.79±15.77)分;对照组性欲(165.28±10.33)分,性唤起(161.31±11.04)分,性高潮(160.38±9.97)分,性心理(163.46±10.05)分,性行为(121.39±6.76)分,综合评分(160.09±8.87)分,组间对比差异具有统计学意义(P<0.05)。观察组术后3个月E2(98.37±8.96)pg/m L,FSH(14.57±1.14)m IU/m L,LH(24.59±2.47)m IU/m L;对照组术后3个月E2(70.04±4.55)pg/m L,FSH(19.81±1.88)m IU/m L,LH(34.57±3.76)m IU/m L,组间对比差异具有统计学意义(P<0.05)。结论:采用次全子宫切除手术应用在子宫肌瘤患者中可以缩短手术时间,减少手术出血,缩短术后肛门排气时间和住院时间,提升患者术后性功能评分,对患者性激素水平影响更小,值得在临床上推广应用。

Objectives：To investigate the effect of total and subtotal hysterectomy on the pelvic floor function and quality of life as well as the value of clinical application.Methods：130 patients with uterine fibroids received hysterectomy in our hospital were divided into observation group and control group.Control group was given total hysterectomy and observation group was given subtotal hysterectomy.The treatment effects of the two groups were compared.Results：In observation group,the indexes were as follow：operating time （70.83 ± 10.31） min,intraoperative blood loss （108.74 ± 14.58） ml,postoperative anal exhaust time （1.13 ± 0.31） d,length of hospital stay （5.66 ± 1.11） d;in control group,the indexes were as follow：operation time （92.38 ± 16.37） min,intraoperative blood loss （142.97 ± 27.15） ml,postoperative anal exhaust time （1.87 ± 0.94） d,length of hospital stay （8.96 ± 2.24） d.The differences between two groups were statistically significant （P〈0.05）.Due to sex life quality,in observation group,the indexes were as follow：sex desire （188.37-17.32） points,sexual arousal （180.45 ± 19.94） points,orgasm （176.98 ± 19.13 mm）,sexual psychology （178.85 ± 17.69）,sex （140.28 ±12.77） points,comprehensive score （176.79 ± 15.77）;in control group,the indexes were as follow：sexual desire （165.28 ± 10.33）,sexual arousal （161.31 ± 11.04）,orgasm （160.38 ± 9.97）,sex psychology （163.46 ±10.05）,sexual behaviour （121.39 ± 6.76） and comprehensive score （160.09 ± 8.87） points.The differences between two groups were statistically significant （P〈0.05）.3 months after the operation,in observation group,the indexes were as follow：E2 （98.37 ± 8.96） pg / mL,FSH （14.57 ± 1.14） mIU / mL,LH （24.59 ± 2.47） mIU /mL;in control group,the indexes were as follow：E2 （70.04 ± 4.55） pg / mL,FSH （19.81 ± 1.88） mIU / mL,LH （34.57 ± 3.76） mIU/mL.The differences between two groups were statistically significant （P〈0.05）.Conclusion：Subtotal hysterectomy in patients with uterine fibroids can shorten the operation time,decrease surgicalbleeding,shorten the postoperative anal exhaust time and hospital stay,improve postoperative sexual function score,with less effect on sex hormone levels in patients,which is worthy of popularization and application in clinic.