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目的了解子宫全切除术后患者的远期盆底功能情况。方法选取2005年1月—2006年7月于武汉市江夏区第一人民医院因妇科良性疾病(子宫肌瘤、子宫腺肌症、功血)行子宫全切除术的134例患者行随访调查,调查项目包括门诊常规妇科检查、盆底肌肉肌力(PFMS)分级测试、盆底功能影响问卷简表7(PFIQ-7)及盆底功能障碍问卷简表20(PFDI-20)。结果①134例患者为子宫全切除术后6~7年,发生压力性尿失禁89例(66.4%),尿频33例(24.6%),尿急28例(20.9%),便秘29例(21.6%),盆腔器官脱垂11例(8.2%);②PFMS测试结果:肌力Ⅰ级2例(1.5%),Ⅱ级48例(35.8%),Ⅲ级71例(53.0%),Ⅳ级13例(9.7%);③PFIQ-7评分的中位数为0分(0,49),PFDI-20评分的中位数为5分(0,37)。结论子宫全切除术对患者远期盆底功能可能存在影响,主要为压力性尿失禁。
Objective To understand the pelvic floor function of patients after hysterectomy. Methods From January 2005 to July 2006, 134 patients underwent total hysterectomy for gynecological benign diseases (uterine fibroids, adenomyosis, dysfunctional uterine bleeding) in Jiangxia First People ’s Hospital of Wuhan City were followed up. The survey included routine gynecological examinations, classification of pelvic muscular force (PFMS), pelvic floor function questionnaire 7 (PFIQ-7) and pelvic floor dysfunction questionnaire 20 (PFDI-20). RESULTS: Thirty-four cases (66.4%) had urinary incontinence, 33 cases (24.6%) had urinary frequency, 28 cases (20.9%) had urinary urgency, 29 cases (21.6% ), Pelvic organ prolapse in 11 cases (8.2%); ②PFMS test results: muscle Ⅰ grade in 2 cases (1.5%), Ⅱ grade in 48 cases (35.8%), Ⅲ grade in 71 cases (53.0%), Ⅳ grade in 13 cases (9.7%). The median of PFIQ-7 scores was 0 (0, 49) and the median of PFDI-20 scores was 5 (0, 37). Conclusions Total hysterectomy may have long-term pelvic floor function in patients with stress urinary incontinence.