宫颈癌根治术后患者发生盆底功能障碍性疾病的影响因素及预防措施

Influencing factors and preventive measures of pelvic floor dysfunction in patients after radical hysterectomy for cervical cancer

目的调查宫颈癌患者术后发生盆底功能障碍性疾病(pelvic fl oor dysfunction,PFD)现状,分析影响因素并提出预防措施。方法选取2023年1—7月在长沙市某三级甲等医院住院的宫颈癌根治术后患者178例为调查对象,使用自行设计的问卷对患者进行横调查,并使用Logistic回归分析宫颈癌根治术后患者盆底功能障碍性疾病的影响因素。结果178例宫颈癌根治术后患者中,105例患者(58.99%)存在盆底功能障碍性疾病,单因素分析结果显示,年龄、妊娠次数、分娩方式、肿瘤直径、绝经、便秘、留置导尿管时间、阴道切除长度均是影响宫颈癌根治术后患者发生盆底功能障碍性疾病的因素(P<0.05),多因素Logistic回归分析结果显示,绝经、便秘、妊娠次数、分娩方式、留置导尿管时间、阴道切除长度为宫颈癌根治术后患者发生盆底功能障碍性疾病的影响因素(P<0.05)。结论宫颈癌根治术后患者女性盆底功能障碍(female pelvic fl oor dysfunction,FPFD)发生率高,绝经、便秘、妊娠次数≥3,阴道分娩、留置导尿管时间≥7 d、阴道切除长度≥3 cm是宫颈癌根治术后患者发生FPFD的危险因素,提示护理人员应给予此类患者更多关注,制定盆底康复训练计划,早期评估FPFD的发生,尽早采取有针对性的措施进行干预。

Objective To investigate the current status of pelvic floor dysfunction(PFD)in cervical cancer patients after surgery,analyze its influencing factors,and propose intervention measures.Methods A total of 178 patients who underwent radical hysterectomy for cervical cancer and were hospitalized at a tertiary grade-A hospital in Changsha from January to July 2023 were selected as the study subjects.A self-designed questionnaire was used to conduct a cross-sectional survey on these patients.Logistic regression analysis was used to analyze the influencing factors of pelvic floor dysfunction in patients after radical hysterectomy for cervical cancer.Results Among the 178 patients who underwent radical hysterectomy for cervical cancer,105 patients(58.99%)had pelvic floor dysfunction.Univariate analysis showed that the factors affecting the occurrence of pelvic floor dysfunction in these patients included the age,number of pregnancies,mode of delivery,tumor diameter,menopause,constipation,duration of indwelling urinary catheter,and length of vaginal resection(P<0.05).Multivariate Logistic regression analysis showed that the factors aff ecting the occurrence of pelvic floor dysfunction in these patients included the menopause,constipation,number of pregnancies,mode of delivery,duration of indwelling urinary catheter,and length of vaginal resection(P<0.05).Conclusion The incidence of female pelvic floor dysfunction(FPFD)is high in patients after radical hysterectomy for cervical cancer.Menopause,constipation,number of pregnancies≥3,vaginal delivery,duration of indwelling urinary catheter≥7 days,and a vaginal excision length≥3 cm are risk factors for FPFD in these patients.This suggests that nursing staff should pay more attention to such patients,develop pelvic floor rehabilitation training plans,conduct early assessments for FPFD,and implement targeted interventions as soon as possible.