全子宫切除术后发生盆底功能障碍的影响因素分析

Influencing factors of pelvic floor dysfunction in patients after total hysterectomy

目的探讨全子宫切除术后盆底功能障碍发生的影响因素。方法选取2016年1月至2017年1月于安阳市第三人民医院行全子宫切除术的患者122例,根据患者术后是否发生盆底功能障碍分为功能障碍组(32例)和无功能障碍组(90例),收集两组患者的临床资料及可疑危险因素,分析全子宫切除术后盆底功能障碍发生的危险因素。结果单因素分析结果示,功能障碍组和无功能障碍组患者在年龄、分娩次数、绝经、留置尿管时间、便秘、慢性咳嗽方面比较差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄(OR=3.164,95%CI1.214~16.154)、分娩次数(OR=2.614,95%CI1.124~14.544)、绝经(OR=3.002,95%CI1.354~18.154)、留置尿管时间(OR=2.816,95%CI1.266~16.452)、便秘(OR=2.557,95%CI1.301~13.647)、慢性咳嗽(OR=3.644,95%CI1.503~15.990)为全子宫切除术后发生盆底功能障碍的危险因素。结论全子宫切除术后盆底功能障碍发生的危险因素较多,临床中针对性实施预防和干预,对降低全子宫切除术后盆底功能障碍的发生有重要价值。

Objective To investigate the occurrence and influencing factors of postoperative pelvic floor dysfunction in patients undergoing total hysterectomy. Methods A total of 122 patients undergoing total hysterectomy in the Third People’s Hospital of Anyang from January 2016 to January 2017 were enrolled. The patients were divided into dysfunction group (32 cases) and non-dysfunction group according to whether pelvic floor dysfunction occurred after operation. The clinical data and suspicious risk factors of the two groups of patients were collected to analyze the risk factors of postoperative pelvic floor dysfunction after total hysterectomy. Results Univariate analysis showed that there were significant differences in age, delivery times, menopause, indwelling catheter time, constipation, and chronic cough in patients in dysfunction group and non-dysfunction group (P<0.05). Multivariate Logistic regression analysis showed that age (OR=3.164, 95%CI 1.214-16.154), delivery times (OR=2.614, 95%CI 1.124-14.544), menopause (OR=3.002, 95%CI 1.354-18.154), indwelling catheter time (OR=2.816, 95% CI 1.266-16.452), constipation (OR=2.557, 95%CI 1.301-13.647), chronic cough (OR=3.644, 95% CI 1.503-15.990) were risk factors for pelvic floor dysfunction after total hysterectomy. Conclusions There are many risk factors for pelvic floor dysfunction after total hysterectomy. Targeted prevention and intervention in clinical practice are of great value in reducing the occurrence of pelvic floor dysfunction after total hysterectomy.