子宫肌瘤切除术后患者性生活质量调查及对策建议

Postoperative sexual life quality investigation of women undergoing myomectomy and its countermeasures

目的:调查子宫肌瘤切除术女性术后性生活质量并分析其影响因素,提出对策。方法:选择2020年12月-2023年12月本院收治的98例子宫肌瘤患者,均行子宫肌瘤切除术,以女性性功能指数(FSFI)调查患者手术前后性生活质量,术后3个月以汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)及婚姻调适测定量表(MAT)评估患者心理状况及婚姻调适水平,多因素logistic回归分析患者术后性生活质量影响因素。结果:98例患术后FSFI各维度评分均总分(27.34±4.32分)均较术前(29.10±3.12分)降低(P<0.05);患者不同年龄、文化程度、家庭月收入、职业状况、手术方式、心理状况及婚姻调适水平均与术后性生活质量有关(P<0.05);多因素logistic回归分析显示,年龄大(OR=3.155,95%CI 1.309~7.607)、HAMD评分高(OR=4.604,95%CI 1.483~14.295)、手术方式腹腔镜下子宫切除术(OR=3.397,95%CI 1.207~9.563)均是患者术后性生活质量的独立影响因素。结论:子宫肌瘤切除术患者术后性生活质量普遍降低,且患者年龄大、手术方式为腹腔镜下子宫切除术、心理状况不佳均是其独立影响因素,临床可通过加强宣教、心理护理、提高社会支持度及运动指导等进行干预。

Objective:To investigate the sexual life quality of women after myomectomy,and to analyze its influencing factors and countermeasures.Methods:98 patients with uterine fibroids who had undergone myomectomy in hospital from December 2020 to December 2023 were selected in this survey.The quality of sexual life of the patients was investigated by female sexual function index(FSFI).The psychological status and the marital adjustment level of the patients in 3 months after operation were evaluated by Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD)and marriage adjustment test(MAT).Multivariate logistic regression was used to analyze the influencing factors of the postoperative sexual life quality of the patients who had undergone myomectomy.Results:The postoperative score of the total FSFI each dimension(27.34±4.32 points)of 98 patients after operation was significantly lower than that(29.10±3.12 points)before operation(P<0.05).The age,the education level,the family monthly income,the occupational status,the surgical method,the psychological status and the marital adjustment level of the patients were all related to their postoperative sexual life quality(P<0.05).Multivariate logistic regression analysis showed that the advanced age(OR=3.155,95%CI 1.309-7.607),the high HAMD score(OR=4.604,95%CI 1.483-14.295)and the surgical method of laparoscopic myomectomy(OR=3.397,95%CI 1.207-9.563)of the patients were all the independent factors affecting their postoperative sexual life quality.Conclusion:The postoperative sexual life quality of the patients with myomectomy is generally low.The advanced age,the surgical method of laparoscopic myomectomy and the low psychologic status of the patients are all the independent factors affecting their postoperative sexual life quality.Clinical intervention can be carried out by strengthening the propaganda and education,by providing the psychological nursing,by improving social support and by guiding the exercise.