子宫切除术后盆底超声参数、尿动力学指标变化及康复治疗的效果

The Changes of Pelvic Floor Ultrasound Parameters and Urodynamic Indexes after Hysterectomy and the Effect of Rehabilitation Treatment

本研究探讨宫颈癌患者行子宫全切手术前后盆底超声参数、尿动力学指标的变化及采用盆底康复治疗的效果。选取在我院实施子宫全切手术的137例宫颈癌患者进行临床研究。所有患者手术前、术后3个月检测盆底超声参数、尿动力学参数。其中120例患者术后接受盆底康复治疗。结果显示:手术后患者的膀胱颈降低测定值、尿道旋转角度测定值、静息状态下膀胱颈尿道后角度、最大Valsalva状态下膀胱尿道后角、膀胱颈与耻骨联合下方之间的垂直距离(BSD)测定值与手术前分别进行对比,均一定程度地增大(P<0.05);在手术后,患者的膀胱顺应性、最大尿流率、最大逼尿肌压力测定值均较手术前显著降低(P<0.05),最大膀胱容量较手术前显著增大(P<0.05);子宫全切手术对宫颈癌患者的盆底功能及膀胱排尿功能均会产生较为明显的不良影响,这部分患者在手术后应该给予适当的康复治疗以促进功能的恢复,从而改善患者的生活质量。

This study explored the changes of pelvic floor ultrasound parameters and urodynamic parameters before and after total hysterectomy in patients with cervical cancer and the effect of pelvic floor rehabilitation.137 cases of cervical cancer patients undergoing total hysterectomy were selected for clinical research.All patients were tested for pelvic floor ultrasound parameters and urodynamic parameters before and 3 months after surgery,among them,120 patients received pelvic floor rehabilitation after surgery.The results showed:the measured value of the bladder neck reduction,the urethral rotation angle,the posterior angle of the bladder neck in the resting state,the posterior angle of the bladder and the urethra in the maximum Valsalva state,and the vertical distance between the bladder neck and the underside of the pubic symphysis(BSD)all increased to a certain extent compared with those before the operation(P<0.05).After the operation,the patient’s bladder compliance,maximum urine flow rate,and maximum detrusor pressure were significantly lower than those before the operation(P<0.05),and the maximum bladder volume was significantly increased(P<0.05).Total hysterectomy will have obvious adverse effects on the pelvic floor function and bladder voiding function for patients with cervical cancer.This part of patients should be given appropriate rehabilitation after the operation to promote the recovery of function and improve the quality of life.