阴道涂抹雌激素联合盆底康复治疗对全子宫切除术后患者性生活质量的影响

Effect of vaginal estrogen smearing combined with pelvic floor rehabilitation on quality of female sexual life after total hysterectomy

目的探讨阴道涂抹雌激素联合盆底康复治疗对子宫全切术后患者性生活质量的影响。方法选择因子宫良性病变行子宫全切术患者80例,随机分为观察组和对照组,各40例。子宫全切术后4个月,观察组采用阴道用雌激素联合盆底康复治疗,对照组采用盆底康复治疗,均治疗至术后6个月。比较两组子宫全切术前、术后4个月、术后6个月的Ⅰ类、Ⅱ类盆底肌纤维肌力、盆底综合肌电位及国际标准盆腔器官脱垂/尿失禁性生活质量问卷-12(PISQ-12)评分。结果术后4个月,两组患者Ⅰ类、Ⅱ类盆底肌纤维肌力、综合肌电位及PISQ-12评分均低于术前(均P<0.05);术后6个月,两组上述指标均高于术后4个月,且观察组Ⅰ类、Ⅱ类盆底肌纤维肌力及PISQ-12评分均高于对照组(均P<0.05)。结论阴道涂抹雌激素联合盆底康复治疗用于改善子宫全切术后患者性生活质量安全有效。

Objective To investigate the effect of vaginal estrogen smearing combined with pelvic floor rehabilitation on the quality of female sexual life after total hysterectomy. Methods Eighty patients with uterine benign lesions undergoing total hysterectomy were enrolled and randomly divided into observation group and control group,with 40 cases in each group.Four months after total hysterectomy,the observation group was treated with vaginal estrogen combined with pelvic floor rehabilitation,and the control group was treated with pelvic floor rehabilitation, both were treated until 6 months after surgery.Type Ⅰ/Ⅱ muscle strength of pelvic floor muscle fibers,pelvic total myoelectric potential ,and the International Standard Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire(PISQ-12) score were compared between the two groups before total hysterectomy,4 and 6 months after surgery. Results Four months after surgery,type Ⅰ/Ⅱ muscle strength of pelvic floor muscle fibers,total myoelectric potential ,and PISQ-12 score were lower in the two groups compared with those before surgery (all P <0.05);six months after surgery,the indices mentioned above were higher in the two groups compared with those at month 4 postoperatively,and the observation group obtained higher type Ⅰ/Ⅱ muscle strength of pelvic floor muscle fibers and higher PISQ-12 score than the observation group(all P <0.05). Conclusion Vaginal estrogen smearing combined with pelvic floor rehabilitation is safe and effective in improving quality of female sexual life after total hysterectomy.