改良阴式子宫切除术在老年女性子宫脱垂患者治疗中的应用效果观察

Observation on the effect of modified vaginal hysterectomy in the treatment of senile female patients sufferingfrom uterine prolapse

目的探讨改良阴式子宫切除术治疗老年女性子宫脱垂对患者氧化损伤指标的影响。方法选择2018年1月—2020年9月本院收治的86例老年女性子宫脱垂患者作为研究对象,采用随机数表法分为A组和B组两组,每组各43例。A组行传统阴式子宫切除术,B组行改良阴式子宫切除术,两组术后均随访1年。比较两组手术时间、住院时间及手术出血量,术前、术后1周氧化损伤指标及术前、随访1年后阴道前壁盆腔脱垂分度(POP-Q各指示点位置)及生活质量评分。结果B组住院时间短于A组,手术出血量少于A组,差异有统计学意义(P<0.05);而两组手术时间比较,差异无统计学意义(P>0.05)。与术前比较,术后1周两组血清缺血修饰清蛋白(IMA)、肌红蛋白(MYO)水平均升高,但B组低于A组;血清总抗氧化能力(TAC)水平均降低,但B组高于A组,差异均有统计学意义(均P<0.05)。与术前比较,随访1年后两组POP-Q各指示点位置均下降,且B组低于A组;而两组社会、认知、躯体及角色领域评分均升高,且B组高于A组,差异均有统计学意义(均P<0.05)。结论改良阴式子宫切除术可缩短老年女性子宫脱垂患者住院时间,减少手术出血量,减轻机体氧化受损,降低POP-Q各指示点位置,进而可提高患者生活质量。

Objective To investigate the impact of modified vaginal hysterectomy on oxidative damage index in the treatment of older women suffering from uterine prolapse.Methods A total of 86 elderly female patients with uterine prolapse who were admitted to our hospital from January 2018 to September 2020 were enrolled as study objects,and they were divided into Group A and group B using the random number table method,with 43 cases in each group.Group A underwent a traditional vaginal hysterectomy,and group B underwent a modified vaginal hysterectomy.Both groups were followed up for 1 year.The duration of operation,length of hospital stay,amount of blood loss,oxidative injury indexes before and 1 week after surgery,and the score of anterior vaginal pelvic prolapse(POP-Q locations of each indicator point)at one year after surgery and quality of life were compared between the two groups.Results The hospitalization time of group B was shorter than that of group A,and the amount of surgical bleeding was less than that of group A,with statistical significance(P<0.05).There was no significant difference in operation time between the two groups(P>0.05).The levels of serum ischemia-modified albumin(IMA)and myoglobin(MYO)in both groups were increased at 1 week after the operation,but those in group B were lowerthan those in group A.Serum total antioxidant capacity(TAC)levels were decreased in both two groups,but that of group B was higher than that of group A,the differences were statistically significant(ALL P<0.05).After 1 year of follow-up,the pop-Q indicator locations of both groups decreased,and those of group B were lower than those in group A.The scores of social,cognitive,physical,and role domains in the two groups increased,and those of group B were higher than group A.The differences were statistically significant(P<0.05).Conclusions Modified vaginal hysterectomy could shorten the length of hospital stay,reduce the amount of blood loss,reduce the oxidative damage to the body,reduce the position of pop-Q indicator points,and improve the quality of life of elderly female patients with uterine prolapse.