阴式手术与开腹手术对子宫良性肿瘤患者炎性应激反应、盆底功能及性生活质量的影响

Effects of Vaginal and Open Surgery on Inflammatory Stress Response,Pelvic Floor Function and Sexual Quality of Life in Patients with Uterine Benign Tumor

目的:探讨阴式手术与开腹手术对子宫良性肿瘤患者盆底功能、炎性应激反应及性生活质量的影响。方法:回顾性分析我院自2017年3月~2019年1月期间收治的子宫良性肿瘤患者78例的临床资料,上述患者根据手术方案的不同分为A组(n=38,给予开腹手术治疗)和B组(n=40,给予阴式手术治疗),对比两组患者围术期指标、炎性应激指标[白介素-6(IL-6)、C反应蛋白(CRP)、皮质醇(Cor)]、盆底功能障碍发生率、并发症发生率及性生活质量。结果:B组术后排气时间、手术时间、住院时间、术后下床时间短于A组,术中出血量少于A组(P<0.05)。两组术后2 d的IL-6、CRP、Cor均升高,但B组低于A组(P<0.05)。B组患者盆底功能障碍发生率为12.50%(5/40),低于A组的36.84%(14/38)(P<0.05)。两组患者术后1年女性性功能指数量表(FSFI)评分均较术前增加,且B组高于A组(P<0.05)。B组术后并发症发生率低于A组(P<0.05)。结论:与开腹手术相比,阴式手术应用于子宫良性肿瘤患者,可有效改善围术期指标、炎性应激反应、盆底功能及性生活质量,减少并发症发生率。

Objective:To investigate the Effects of vaginal and open surgery on pelvic floor function,inflammatory stress response and sexual quality of life in patients with uterine benign tumor.Methods:The clinical data of 78 patients with uterine benign tumor from March 2017 to January 2019 were analyzed retrospectively,the patients were divided into group A(n=38,treatment by open surgery)and group B(n=40,treatment by vaginal surgery)according to the different operative plans,the indexes of perioperative period,inflammatory stress indexes[Interleukin-6(IL-6),C-reactive protein(CRP),Cortisol(Cor)],pelvic floor dysfunction,complications and sexual quality of life were compared between the two groups.Results:The time of exhaust,operation,hospitalization and getting out of bed in group B were shorter than that in group A,and the amount of bleeding was less than that in group A(P<0.05).The levels of IL-6,CRP and cor were all increased in two groups,but the level in group B was lower than that in group A(P<0.05).The incidence of pelvic floor dysfunction in group B was 12.50%(5/40),lower than 36.84%(14/38)in group A(P<0.05).The score of Female sexual function index scale(FSFI)in the two groups was higher than that before operation,and the score in group B was higher than that in group A(P<0.05).The incidence of postoperative complications in group B was lower than that in group A(P<0.05).Conclusion:Compared with laparotomy,vaginal surgery can effectively improve the perioperative indicators,inflammatory stress response,pelvic floor function and sexual quality of life,and reduce the incidence of complications.