宫颈癌根治术后发生膀胱麻痹的影响因素

Analysis of influencing factors of bladder paralysis in patients with cervical cancer after radical surgery

目的探讨宫颈癌根治术后患者发生膀胱麻痹的影响因素。方法选取2020年3月至2022年7月在江西省肿瘤医院行根治性手术治疗的86例宫颈癌患者为研究对象,分析宫颈癌根治术后患者发生膀胱麻痹的影响因素。结果86例患者中宫颈癌根治术后出现膀胱麻痹30例(34.88%),未出现膀胱麻痹56例(65.12%)。单因素分析显示,淋巴结切除数目、手术途径、宫旁组织切除宽度、阴道断端长度、导尿管留置时间、手术范围与宫颈癌根治术后患者发生膀胱麻痹有关,差异有统计学意义(P<0.05);年龄、临床分期、病理类型、术前放化疗、术中出血量、手术时间、术后住院时间与宫颈癌根治术后患者发生膀胱麻痹无关,差异无统计学意义(P>0.05)。多因素分析显示,淋巴结切除数目≥10个(OR=2.692,95%CI:1.051~6.899)、宫旁组织切除宽度≥3cm(OR=5.000,95%CI:1.924~12.996)、阴道断端长度≥3cm(OR=4.325,95%CI:1.669~11.207)、导尿管留置时间≥5d(OR=3.574,95%CI:1.405~9.090)、广泛子宫切除(OR=3.067,95%CI:1.127~8.341)是宫颈癌根治术后患者发生膀胱麻痹的高危因素(P<0.05)。结论宫颈癌根治术后患者易发生膀胱麻痹,其发生与淋巴结切除数目、宫旁组织切除宽度、阴道断端长度、导尿管留置时间、手术范围有关。

Objective To investigate the influencing factors of bladder paralysis in patients with cervical cancer after radical surgery.Methods 86 patients with cervical cancer who underwent radical surgery in Jiangxi Cancer Hospital from March 2020 to July 2022 were selected as the study subjects.Data were collected and the influencing factors of bladder paralysis in patients with cervical cancer after radical surgery were analyzed.Results Among the 86 patients,30 patients(34.88%)had bladder paralysis after radical surgery,and 56 patients(65.12%)had no bladder paralysis;Univariate analysis showed that the number of lymph nodes removed,the surgical approach,the removal width of para uterine tissues,the length of vaginal stump,the indwelling time of urinary catheter,and the scope of surgery were related to the occurrence of bladder paralysis in patients after radical surgery for cervical cancer,and the difference was statistically significant(P<0.05);Age,clinical stage,pathological type,preoperative radiotherapy and chemotherapy,intraoperative bleeding,operation time,and postoperative hospital stay were not related to the occurrence of bladder paralysis in patients with cervical cancer after radical surgery,and the difference was no statistically significant(P>0.05);Multivariate analysis showed that the number of lymph nodes removed was≥10(OR=2.692,95%CI:1.051-6.899),the width of para uterine tissues removed was≥3cm(OR=5.000,95%CI:1.924-12.996),the length of vaginal stump was≥3cm(OR=4.325,95%CI:1.669-11.207),the indwelling time of urinary catheter was≥5d(OR=3.574,95%CI:1.405-9.090),extensive hysterectomy(OR=3.067,95%CI:1.127-8.341)were high risk factors for bladder paralysis in patients with cervical cancer after radical surgery(P<0.05).Conclusion Bladder paralysis is easy to occur in patients with cervical cancer after radical surgery,which is related to the number of lymph nodes removed,the width of para uterine tissues removed,the length of vaginal stump,the duration of catheter indwelling,and the scope of surgery.