筋膜外全子宫切除及双侧附件切除术对早期子宫内膜癌患者预后及排尿功能、膀胱功能的影响

Effect of Total Epifascial Hysterectomy and Bilateral Adnexectomy on Prognosis,Urination Function and Bladder Function in Patients with Early Endometrial Cancer

目的研究筋膜外全子宫切除及双侧附件切除术对早期子宫内膜癌患者预后及排尿功能、膀胱功能的影响。方法选择医院从2019年10月至2021年10月收治的94例早期子宫内膜癌患者。将其按照手术方案的差异分为观察组及对照组,每组各47例。对照组开展广泛性全子宫切除术,观察组则开展筋膜外全子宫切除及双侧附件切除术。分析两组手术指标,排尿功能、膀胱功能,术后并发症以及SAS和SDS评分等方面的差异。结果观察组手术时长、术中失血量及住院天数分别为(76.28±2.31)min、(136.22±24.88)mL、(13.45±2.61)d,相较于对照组的(101.37±4.29)min、(170.59±31.62)mL、(16.78±4.10)d更低(均P<0.05)。观察组术后排尿量、最大尿流率、平均尿流率及最大逼尿肌压力分别为(370.89±54.20)mL、(24.16±3.74)mL/s、(13.42±3.84)mL/s、(41.45±6.25)cm H2O,相较于对照组的(339.21±51.37)m L、(22.08±3.28)mL/s、(11.20±3.46)mL/s、(37.51±6.09)cm H2O均更高,而残余尿量为(6.42±1.34)mL,低于对照组的(8.02±1.62)mL(均P<0.05)。观察组术后膀胱壁厚度、膀胱最大尿容量及正常尿意膀胱容量分别为(3.34±0.48)mm、(410.77±71.25)m L、(312.47±62.35)mL,相较于对照组的(3.60±0.52)mm、(444.16±76.45)mL、(339.58±64.15)mL均更低(均P<0.05)。观察组并发症总发生率低于对照组(P<0.05)。观察组术后SAS及SDS评分分别相较于对照组均更低(均P<0.05)。结论筋膜外全子宫切除及双侧附件切除术可改善早期子宫内膜癌患者预后,促进排尿功能及膀胱功能的恢复,降低并发症发生风险,改善负性心理情绪。

Objective To study and analyze the effects of total epifascial hysterectomy and bilateral adnexectomy on prognosis,urination function and bladder function in patients with early endometrial cancer.Methods Ninety-four patients with early endometrial cancer admitted to the hospital from October 2019 to October 2021 were selected.The patients were divided into observation group and control group according to the difference of operation plan,with 47 cases in each group.The control group underwent extensive hysterectomy,and the observation group underwent epifascial hysterectomy and bilateral adnexectomy.The differences of operative indexes,urination function,bladder function and postoperative complications and SAS,SDS score between the two groups were analyzed.Results Operation duration,intraoperative blood loss and hospitalization days in the observation group were(76.28±2.31)min,(136.22±24.88)mL and(13.45±2.61)days,respectively,compared with the levels of the control group(101.37±4.29)min,(170.59±31.62)mL and(16.78±4.10)days were lower(all P<0.05).The postoperative urine volume,maximum urine flow rate,average urine flow rate and maximum detrusor muscle pressure in the observation group were(370.89±54.20)mL,(24.16±3.74)mL/s,(13.42±3.84)mL/s,(41.45±6.25)cm H2O,respectively,compared with(6.42±1.34)mL,(22.08±3.28)mL/s,(11.20±3.46)mL/s,(37.51±6.09)cm H2O of the control group were higher,and the residual urine volume in the observation group was(6.42±1.34)mL,it was lower than that of control group(8.02±1.62)mL(all P<0.05).In the observation group,the postoperative bladder wall thickness,maximum bladder volume and normal urinary bladder volume were(3.34±0.48)mm,(410.77±71.25)mL and(312.47±62.35)mL,respectively.Compared with the control group,the levels of(3.60±0.52)mm,(444.16±76.45)mL and(339.58±64.15)mL were lower(all P<0.05).The incidence of complications in observation group was lower than that in control group(P<0.05).The postoperative SAS and SDS scores of the observation group were both lower than those of the control group(all P<0.05).Conclusion Total epifascial hysterectomy and bilateral adnexectomy can improve the prognosis of patients with early endometrial cancer,promote the recovery of urination function and bladder function,and reduce the risk of complications,improve the negative psychological mood.