不同子宫切除手术方案下妇女盆底功能水平的比较

Comparison of pelvic floor function level of women under different hysterectomy programs

目的探讨不同子宫切除手术方案下妇女盆底功能的水平。方法选取2015年10月~2017年1月在我院接受治疗的167例子宫切除手术的患者进行本次研究,按照手术方法分为观察组(腹腔镜全子宫切除术)87例和对照组(腹式全子宫切除术)80例。观察组患者采用腹腔镜全子宫切除术,对照组采用腹式全子宫切除术。结果两组患者手术时间、住院时间、术中出血量、肛门排气时间指标比较,观察组显著低于对照组,差异有统计学意义(P <0.05)。术后患者盆底肌力呈下降趋势,两组患者的盆底肌力检测,术前两组患者比较均无统计学意义,在术后半年,观察组盆底肌力检测,Ⅱ级为26例低于对照组29例,Ⅲ级40例与对照组相等,Ⅳ级为21例高于对照组11例,患者恢复情况高于对照组,差异有统计学意义(P <0.05)。在术后1年,Ⅱ级患者观察组为27例低于对照组32例,Ⅲ级41例,高于对照组38例,Ⅳ级观察组19例显著高于对照组10例,观察组患者的盆底肌力恢复情况高于对照组,差异有统计学意义(P <0.05)。观察组患者的盆底肌疲劳度异常在术后半年观察组发生率为40.22%,对照组为56.25%,术后1年观察组为27.58%,对照组为45.00%,观察组均低于对照组,差异有统计学意义(P <0.05)。术后半年观察组盆底综合肌力异常,发生率为41.38%,对照组为58.75%,术后1年观察组发生率为21.84%,对照组为46.25%,观察组均低于对照组,差异均有统计学意义(P <0.05)。观察组盆底动态压力在术后半年和术后1年的盆底动态压力均显著低于对照组,差异均有统计学意义(P <0.05)。结论不同的子宫切除手术方式对妇女盆底功能水平均有一定的影响,腹式子宫切除术较腹腔镜子宫切除术影响大。

Objective To explore the level of pelvic floor function in women under different hysterectomy procedures. Methods From October 2015 to January 2017, 167 patients treated in our hospital under different hysterectomy programs were selected in this study, and all them were divided into observation group（laparoseopie total hysterectomy, 87 eases） and control group（abdominal total hysterectomy, 80 eases） according to the operation method. Laparoseopie total hysterectomy was used in the observation group and abdominal total hysterectomy was used in the control group. Results The operation tim, hospitalization time, intraoperative blood loss and anal exhaust time of the observation group were significantly lower than those of the control group（P 〈 0.05）. Postoperative pelvic floor muscle strength of patients was on the decline, the pelvic floor muscle strength of two groups was detected, there was no significant difference between the two groups before operation. Six months after operation, the pelvic floor muscle strength of the observation group showed that 26 eases of grade Ⅱ were lower than 29 eases of the control group, 40 eases of grade Ⅲ were equal to the control group, 21 eases of grade IV were higher than 11 eases of the control group, and the recovery of the patients was higher than that of the control group, the difference was statistically signifieant（P 〈 0.05）. One year after operation, in the observation group 27 eases of grade Ⅱ were lower than 32 eases in the control group, 41 eases in the grade Ⅲ were higher than 38 eases in the control group, 19 eases in the grade Ⅳ were significantly higher than 10 eases in the control group, and the recovery of pelvic floor muscle strength in the observation group was higher than that in the control group（P 〈 0.05）. Six months after operation, the incidence of abnormal pelvic floor muscle fatigue was 40.22% in the observation group, 56.25% in the control group, one year after operation, 27.58% in the observation group and 45.00% in the control group. The observation group was lower than the control group, the difference was statistically significant（ P 〈 0.05）. Six months after operation, the incidence of abnormal pelvic floor muscle strength was 41.38% in the observation group, 58.75% in the control group, one year after operation, 21.84% in the observation group and 46.25% in the control group. The observation group was lower than the control group, the difference was statistically significant （ P〈 0.05）. The pelvic floor dynamic pressure in the observation group was significantly lower than that in the control group at six months after operation and one years after operation, the difference was statistically signifieant（P 〈 0.05）. Conclusion Different hysterectomy programs have certain effects on the level of pelvic floor function in women, abdominal hysterectomy is more effective than laparoseopie hysterectomy..