【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。更多还原

【Abstract】 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.更多还原