巨大子宫肌瘤患者根治术后性功能障碍的影响因素研究

Influencing factors of sexual dysfunction in patients with giant hysteromyoma after radical operation

目的观察巨大子宫肌瘤患者全子宫切除术后性功能障碍(sexual dysfunction,SD)情况,并分析SD发生的相关影响因素。方法回顾性分析2017年1月至2021年1月于海南医学院第一附属医院行全子宫切除术的巨大子宫肌瘤患者160例临床资料,根据患者术后6个月时是否发生SD分为发生组与未发生组。分析患者基线资料,探讨影响巨大子宫肌瘤患者全子宫切除术后SD发生的相关影响因素。结果160例巨大子宫肌瘤患者术后6个月,有38例发生SD,发生率为23.75%(38/160);发生组与未发生组患者的年龄、子宫大小、分娩次数、术中出血量、焦虑抑郁比较,差异有统计学意义(P<0.05);组间BMI、肌瘤直径、受教育程度、住院时间、既往腹部手术史、术后并发症、合并基础疾病、盆底肌力、雌二醇、卵泡生成激素、黄体生成激素比较,差异均无统计学意义(P>0.05);经Logistic回归分析结果显示,高龄、子宫大小>孕7周、分娩次数多、术中出血量多、有焦虑抑郁均是巨大子宫肌瘤患者全子宫切除术后发生SD的影响因素(OR>1,P<0.05)。结论巨大子宫肌瘤患者全子宫切除术后具有一定的SD发生风险,可能与高龄、子宫大小>孕7周、分娩次数多、术中出血量多、有焦虑抑郁有关,临床可针对上述因素制定个性化干预策略以降低术后SD的发生率。

Objective To observe the sexual dysfunction(SD)of patients with giant uterine hysteromyoma after total hysterectomy,and analyze the related influencing factors of SD.Methods The clinical data of 160 patients with giant hysteromyoma who underwent total hysterectomy in the First Affiliated Hospital of Hainan Medical College from January 2017 to January 2021 were retrospectively analyzed.According to whether SD occurred at 6 months after operation,the patients were divided into occurrence group and non occurrence group.The baseline data of patients were analyzed to explore the related influencing factors of SD after total hysterectomy in patients with giant hysteromyoma.Results In 160 patients with giant hysteromyoma,SD occurred in 38 patients 6 months after operation,with an incidence of 23.75%(38/160).There were statistically significant differences in age,uterine size,delivery times,intraoperative blood loss,anxiety and depression of patients in the two groups(P<0.05).There was no statistically significant difference in BMI,myoma diameter,education level,length of hospitalization time,previous abdominal surgery history,postoperative complications,basic diseases,pelvic floor muscle strength,estradiol,follicle forming hormone and luteinizing hormone between the two groups(P>0.05).Logistic regression analysis showed that older age,uterine size>7 weeks of pregnancy,more times of delivery,more intraoperative blood loss,anxiety and depression were all influencing factors of SD after total hysterectomy in patients with giant hysteromyoma(OR>1,P<0.05).Conclusion Patients with giant hysteromyoma have a certain risk of SD after total hysterectomy,which may be related to older age,uterine size>7 weeks of pregnancy,more times of delivery,more intraoperative blood loss,and anxiety and depression.Clinically,personalized intervention strategies can be developed for the above factors to reduce the incidence of postoperative SD.