腹腔镜全子宫切除术后盆底功能障碍发生影响因素分析  

Analysis of the influencing factors of the pelvic floor dysfunction occurced after total laparoscopic hysterectomy

作　　者：郑建英 熊矿辉 李朋 张轶欧 ZHENG Jianying;XIONG Kuanghui;LI Peng;ZHANG Yiou(Hangzhou Hospital of Zhejiang Medical and Health Group,Hangzhou,Zhejiang Province,310000;Nan-fang Hospital,Southern Medical University,Guangzhou)

机构地区：[1]浙江省医疗健康集团杭州医院,310000 [2]南方医科大学南方医院

出　　处：《中国计划生育学杂志》2024年第10期2353-2357,共5页Chinese Journal of Family Planning

摘　　要：目的:探究腹腔镜全子宫切除术后盆底功能障碍性疾病(PFD)发生影响因素。方法:回顾性选取2022年1月-2023年1月在本院行腹腔镜全子宫切除术且随访资料完整的子宫良性病变患者71例临床资料,根据患者手术3个月后复查结果统计PFD发生情况,采用logistic回归分析腹腔镜全子宫切除术后PFD发生的影响因素。结果:71例患者中发生盆腔器官脱垂9例、尿失禁5例、性功能障碍4例,总发生率为25.4%;盆底功能异常组年龄>45岁、产次>2次以及术后未进行规律盆底肌功能锻炼占比均高于盆底功能正常组(P<0.05);年龄>45岁(OR=1.709,95%CI 1.062~2.752)、产次>2次(OR=1.539,95%CI 1.048~2.260)、未进行规律盆底肌功能锻炼(OR=1.471,95%CI 1.188~1.821)均为腹腔镜全子宫切除术后PFD发生的独立影响因素(均P<0.05)。结论:腹腔镜全子宫切除术后PFD发生率较高,且受年龄、产次以及术后盆底肌功能锻炼等因素影响,临床应积极开展术后盆底功能锻炼指导和健康教育,提高患者对盆底肌功能锻炼的认识和依从性。Objective:To investigate the influencing factors of the pelvic floor dysfunction(PFD)occurrence of patients after total laparoscopic hysterectomy.Methods:The clinical data of 71 patients with the complete data of the follow-up who had been total laparoscopic hysterectomy caused by benign uterine lesions from January 2022 to January 2023 were selected in this study retrospectively.The occurrence of PFD was statistically analyzed according to the reexamination results of the patients in 3 months after surgery.The influencing factors of PFD occurrence of the patients after total laparoscopic hysterectomy were analyzed by logistic regression analysis.Results:In 71 patients with PFD occurrence after total laparoscopic hysterectomy,there were 9 cases with pelvic organ prolapses,5 cases with urinary incontinence and 4 cases with sexual dysfunction,with a total incidence of 25.4%.The proportions of the age>45 years old,the parity>2 times of the patients without regular pelvic floor muscle function exercise of the patients were significantly higher than those of the patients with normal pelvic floor function(P<0.05).The age>45 years old(OR=1.709,95%CI:1.062-2.752),the parity>2 times(OR=1.539,95%CI:1.048-2.260),no regular pelvic floor muscle function exercise(OR=1.471,95%CI:1.188-1.821)of the patients were the independent influencing factors of their PFD occurrence after total laparoscopic hysterectomy(all P<0.05).Conclusion:The incidence of PFD of the patients after total laparoscopic hysterectomy is relatively high,which is influenced by the age,the party time and the postoperative pelvic floor muscle functional exercise of the patients.The postoperative pelvic floor function exercise guidance and the health education of the patients should be actively carried out in clinic to improve their understanding and compliance of the pelvic floor muscle function exercise.

关 键 词：腹腔镜全子宫切除术 盆底功能障碍 影响因素 

分 类 号：R713.42[医药卫生—妇产科学]