不同全子宫切除术式对子宫肌瘤患者术后尿动力学的影响  

Effects of hysterectomy via different surgical approaches on urodynamics in patients with hysteromyoma

作　　者：白华[1] 熊春秋[1] 黄宁[1] 黄飞凤[1] 马刚[1] 张明铭[1] BAI Hua;XIONG Chun-qiu;HUANG Ning;HUANG Fei-feng;MA Gang;ZHANG Ming-ming(The First Department of Gynecology,the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning 530003,China)

机构地区：[1]广西壮族自治区妇幼保健院妇一科

出　　处：《广西医学》2019年第23期2958-2960,2964,共4页Guangxi Medical Journal

基　　金：广西医疗卫生重点科研课题(重2012023)

摘　　要：目的对比不同全子宫切除术式对子宫肌瘤患者术后尿动力学的影响。方法将180例子宫肌瘤患者随机分为A、B、C 3组,每组60例。A组行传统的经腹全子宫切除术,B组行经腹筋膜内全子宫切除术,C组行经阴道全子宫切除术。比较3组患者术前及术后3个月平均尿流率、最大尿流率;记录3组患者术后3个月及6个月压力性尿失禁的发生情况。结果术后3个月,B组患者平均尿流率、最大尿流率均大于A组、C组(均P<0.05),而A组与C组平均尿流率、最大尿流率差异均无统计学意义(均P>0.05)。术后3个月,B组患者压力性尿失禁发生率低于C组(P<0.05);术后6个月,3组患者压力性尿失禁发生率差异无统计学意义(均P>0.05)。结论与经腹全子宫切除术及经阴道全子宫切除术相比,经腹筋膜内全子宫切除术对子宫肌瘤患者术后排尿功能影响较小。Objective To compare the effects of hysterectomy via different approaches on urodynamics in patients with hysteromyoma.Methods A total of 180 patients with hysteromyoma were randomized into group A,group B and group C,with 60 cases in each group.Group A,group B and group C underwent conventional total abdominal hysterectomy,total transabdominal intrafascial hysterectomy and total transvaginal hysterectomy,respectively.The average and maximum urinary flow rates before operation and at 3 months after operation were compared among the three groups;the incidence of stress urinary incontinence at 3 and 6 months after operation was recorded in the three groups.Results At 3 months after operation,the average and maximum urinary flow rates in group B were higher than those in group A and group C(all P<0.05),whereas there was no statistically significant difference in the average and maximum urinary flow rates between group A and group C(all P>0.05).At 3 months after operation,the incidence rate of stress urinary incontinence in group B was significantly lower than that in group C(P<0.05);there was no statistically significant difference in stress urinary incontinence at 6 months after operation among the three groups(all P>0.05).Conclusion In comparison with total abdominal hysterectomy and total transvaginal hysterectomy,the total transabdominal intrafascial hysterectomy exerts a slighter effect on postoperative urinary function in the patients with hysteromyoma.

关 键 词：全子宫切除 尿流动力学 经腹全子宫切除术 经阴道全子宫切除术 经腹筋膜内全子宫切除术 压力性尿失禁 平均尿流率 最大尿流率 

分 类 号：R713.42[医药卫生—妇产科学]