开腹与腹腔镜对全子宫切除患者盆底功能、生活质量及疗效的影响

Influence of Laparotomy and Laparoscopy on Pelvic Floor Function,Quality of Life and Curative Effect in Patients With Total Hysterectomy

目的 探讨开腹与腹腔镜对行全子宫切除术患者的临床疗效及盆底功能、生活质量、术后康复的影响。方法 选取2019年3月—2022年3月赤峰市医院收治的子宫全切除患者64例作为研究对象,将其随机分为A组和B组,各32例;A组接受传统开腹手术进行全子宫切除,B组采用腹腔镜手术进行全子宫切除。对比两组临床疗效,术前以及术后盆底功能、生活质量以及术后并发症发生情况。结果 B组临床疗效各指标均优于A组,差异有统计学意义(P<0.05);B组术前及术后6个月PFDI-20评分与A组比较,差异无统计学意义(P> 0.05);B组术后3个月PFDI-20评分明显低于A组,差异有统计学意义(P <0.05);B组术前及术后6个月PFIQ-7评分与A组比较,差异无统计学意义(P> 0.05),B组术后3个月PFIQ-7评分明显低于A组,差异有统计学意义(P<0.05);B组术前以及术后6个月的环境、社会、心理以及生理评分与A组比较,差异无统计学意义(P> 0.05),B组术后3个月的环境、社会、心理以及生理评分明显高于A组,差异有统计学意义(P <0.05);B组术后并发症发生率(6.25%)低于A组(28.13%),差异有统计学意义(P <0.05)。结论 腹腔镜相比传统开腹手术对全子宫切除患者,临床治疗效果显著,能够有效降低其并发症的发生,对其盆底功能及生活质量短期内无明显差异。

Objective To investigate the effect of laparotomy and laparoscopy on the clinical efficacy,pelvic floor function,quality of life and postoperative rehabilitation of patients undergoing total hysterectomy.Methods A total of 64 patients with total hysterectomy admitted to Chifeng City Hospital from March 2019 to March 2022were selected as the research objects and randomly divided into group A and group B,32 cases in each group.Group A was undergone conventional open surgery for total hysterectomy,and group B was undergone laparoscopic surgery for total hysterectomy.The clinical efcacy,preoperative and postoperative pelvic floor function,quality of life and postoperative complications were compared between the two groups.Results The indexes of clinical efcacy of group B was better than group A,the difference was statistically significant(P 0.05).The PFDI-20 score of group B was significantly lower than that of group A at 3 months after operation,the difference was statistically significant(P 0.05),and PFIQ-7 score of group B was significantly lower than that of group A 3 months after operation,the difference was statistically significant(P 0.05).The environmental,social,psychological and physiological scores of group B 3 months after operation were significantly higher than those of group A,the differences were statistically significant(P < 0.05).The incidence of postoperative complications in group B(6.25%)was significantly lower than that in group A(28.13%),the difference was statistically significant(P < 0.05).Conclusion Compared with traditional laparotomy,laparoscopy has a significant clinical effect on patients with total hysterectomy,and can effectively reduce the incidence of complications.There is no significant difference in pelvic floor function and quality of life in the short term.