探讨子宫全切术与子宫次全切术对女性盆底功能的影响

The Effect of Total Hysterectomy and Subtotal Hysterectomy on Pelvic Floor Function in Female

目的研究分析子宫全切手术和子宫次全切手术患者术后盆底功能的差异性。方法根据我院2013年1月—2016年1月接收的子宫全切和次全切患者进行分析研究,其中40例患者接受全子宫切除手术,作为A组,30例接受次全子宫切除手术,作为B组,术后对患者进行盆底肌力测试,对比两组的盆底肌功能障碍情况。结果 A组患者有18例子宫盆底肌力低于Ⅳ级,占45.00%,压力性尿失禁(SUI)为4例,盆腔脏器脱垂(POP)为4例。B组有4例子宫盆底肌力低于IV级,占13.33%,SUI为4例,POP为2例,两组盆底肌力对比,差异有统计学意义(P<0.05),SUI和POP对比,差异无统计学意义(P>0.05)。结论子宫全切手术患者术后出现盆底功能障碍的几率比子宫次全切手术患者要高,临床使用何种术式,应该根据患者的具体情况来权衡,不可轻易切除,应对患者术后生活给予考量。

[Abstract] Objective To investigate the difference of pelvic foor function after total hysterectomy or subtotal hysterectomy. Methods From January 2013 to January 2016, patients who underwent total hysterectomy or subtotal hysterectomy were analyzed and studied in our hospital, 40 patients who underwent total hysterectomy were taken as the group A, 30 patients who underwent subtotal hysterectomy were taken as group B, pelvic foor muscle strength test was performed and the pelvic foor muscle dysfunction in the two groups was compared. Results There were 18 patients in group A whose pelvic foor muscle strength was lower than grade Ⅳ, accounting for 45.00%, 4 cases of SUI and 4 cases of POP. There were 4 patients in group B whose pelvic foor muscle strength was lower than grade IV, accountingfor 13.33%, 4 cases of SUI and 2 cases of POP, the difference of pelvic foor muscle strength between the two groups was statistically signifcant （P 〈 0.05）, the difference between SUI and POP was not statistically signifcant （P 〉 0.05）. Conclusion The incidence of pelvic foor dysfunction in patients undergoing hysterectomy is higher than in patients undergoing subtotal hysterectomy, what kind of operation should be used in clinic should be weighed according to the patient＇s condition. Uterus should not be removed easily, and the patient＇s postoperative life should be considered.