河北医科大学学报 ›› 2021, Vol. 42 ›› Issue (10): 1171-1174,1184.doi: 10.3969/j.issn.1007-3205.2021.10.011

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LTH术结合圆韧带悬吊术对子宫肌瘤患者术后并发PFD的预防效果分析

  

  1. 河北省邢台市第三医院妇科,河北 邢台 054000
  • 出版日期:2021-10-25 发布日期:2021-10-28
  • 作者简介:修晨(1984-),女,河北邢台人,河北省邢台市第三医院主治医师,医学学士,从事妇科疾病诊治研究。
  • 基金资助:
    河北省医学科学研究课题计划(20201564)

Preventive effect of LTH combined with round ligament suspension on postoperative PFD in patients with uterine leiomyoma

  1. Department of Gynecology, the Third Hospital of Xingtai City, Hebei Province, Xingtai 054000, China
  • Online:2021-10-25 Published:2021-10-28

摘要: 目的 研究腹腔镜全子宫切除术(laparoscopic total hysterectomy,LTH)结合圆韧带悬吊术对子宫肌瘤患者术后并发盆底功能障碍性疾病(pelvic floor dysfunction,PFD)的预防效果。
方法 选取医院收治的112例子宫肌瘤患者,根据随机数字表法分为观察组(56例)、对照组(56例)。两组患者均接受LTH治疗,其中观察组联合圆韧带悬吊术。比较两组患者治疗后PFD的情况。根据是否发生PFD分为发生组、未发生组,比较两组患者临床病历资料,并采用Logistic模型分析术后并发PFD的危险因素。
结果 术后随访6个月,共有38例患者发生PFD,其中观察组尿频尿急、压力性尿失禁发生率明显低于对照组(P<0.05)。观察组患者住院时间、排气时间、PFIQ-7评分明显低于对照组(P<0.05)。Logistic回归分析结果显示,糖尿病(OR=2.208,95%CI:1.457~3.345)、孕产次(OR=1.592,95%CI:1.059~2.393)、子宫肌瘤直径(OR=2.545,95%CI:1.076 ~6.016)以及年龄(OR=2.358,95%CI:1.275~4.364)是术后发生PFD的危险因素(P<0.05)。
结论 糖尿病、孕产次、子宫肌瘤直径以及年龄型是子宫肌瘤患者LTH术后发生PFD的危险因素,LTH术结合圆韧带悬吊术可降低术后PFD发生风险。


关键词: 平滑肌瘤, 腹腔镜检查, 子宫切除术

Abstract: Objective To analyze the preventive effect of laparoscopic total hysterectomy(LTH) combined with round ligament suspension on postoperative pelvic floor dysfunction(PFD) in patients with uterine leiomyoma. 
Methods A total of 112 patients with uterine leiomyoma admitted to our hospital were divided into observation group(n=56) and control group(n=56) according to the random number table method. Patients in both groups were treated with LTH, and the observation group was combined with round ligament suspension. The PFD was compared in the two groups after different treatment. According to presence of PFD, the patients in the two groups were divided into the occurrence group and the non-occurrence group. The clinical records of the two groups were compared, and the risk factors of postoperative PFD were analyzed by Logistic regression model. 
Results After 6 months of follow-up, there were 38 patients with PFD. The incidence of frequent urination and stress urinary incontinence in the observation group was significantly lower than that in the control group(P<0.05). The hospitalization days, exhaust time and PFIQ-7 score of the patients in the observation group were significantly lower than those in the control group(P<0.05). Logistic regression analysis showed that diabetes(OR=2.208, 95%CI:1.457-3.345), number of pregnancies(OR=1.592, 95%CI:1.059-2.393), diameter of uterine leiomyoma(OR=2.545, 95%CI:1.076-6.016) and age(OR=2.358, 95%CI:1.275-4.364) were the risk factors for postoperative PFD(P<0.05). 
Conclusion The risk factors of PFD in patients with uterine leiomyoma after LTH were diabetes mellitus, number of pregnancies and delivery, diameter of uterine leiomyoma and age type. LTH combined with round ligament suspension can reduce the risk of postoperative PFD.


Key words: leiomyoma, laparoscopy, hysterectomy