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目的:探讨全子宫切除术对绝经前后妇女泌尿系统及肠功能的影响。方法:将全子宫切除术的患者分3组,绝经前组、绝经早期组、绝经晚期组;比较3组患者术后肛门恢复排气、排便时间、尿管留置时间;比较3组患者术后1个月、1年膀胱及肠功能情况。结果:绝经前组患者术后恢复肛门排气、排便的时间最早,尿管留置的时间最短[分别为(37.46±3.55)h,(65.72±5.51)h,(28.92±3.04)h],绝经早期组次之[分别为(43.30±4.50)h,(74.34±8.25)h,(35.67±3.15)h],绝经晚期组最长[分别为(49.23±4.34)h,(80.04±6.43)h,(37.38±3.46)h];两两比较均有统计学意义(P<0.05)。随访术后1个月和1年尿频、排尿等待、便秘的发生率,绝经前组[尿频(6.4%、0),排尿等待(8.0%、0),便秘(14.5%、5.4%)]低于绝经早期组[尿频(21.1%、10.2%),排尿等待(21.1%、8.1%),便秘(30.7%、18.3%)](P<0.05),亦低于绝经晚期组[尿频(36.1%、23.5%),排尿等待(38.8%、23.5%),便秘(47.2%、32.3%)](P<0.01);术后1个月、1年尿失禁的发生率绝经前组最低,绝经晚期组最高,两组相比差异有统计学意义(P<0.05)。结论:全子宫切除术对妇女的泌尿系统及肠功能均有一定的影响,尤其是对绝经后的妇女影响更甚。
Objective: To investigate the effect of total hysterectomy on urinary system and intestinal function in women before and after menopause. Methods: The total hysterectomy patients were divided into 3 groups, the premenopausal group, the early menopausal group, the late menopausal group; compared anal perfusion exhaust time, defecation, urinary catheter indwelling time after 3 groups of patients; 1 month, 1 year bladder and bowel function. Results: In the premenopausal group, the time of anal exhaust, earliest defecation and indwelling catheter were the shortest [(37.46 ± 3.55) h and (65.72 ± 5.51) h and (28.92 ± 3.04) h respectively] (43.30 ± 4.50) h, (74.34 ± 8.25) h and (35.67 ± 3.15) h in the early group and the longest in the postmenopausal group [49.23 ± 4.34 and 80.04 ± 6.43, respectively] , (37.38 ± 3.46) h] respectively; each comparison was statistically significant (P <0.05). The frequency of urinary awaiting, constipation, urinary frequency (6.4%, 0), micturition waiting time (8.0%, 0), constipation (14.5%, 5.4%) was significantly lower at 1 month and 1 year after operation Urinary frequency (21.1%, 8.1%), constipation (30.7%, 18.3%) (P <0.05) in the early menopausal group were also lower than those in the late menopausal group (urinary frequency: 36.1% , Urinary waiting time (38.8%, 23.5%), constipation (47.2%, 32.3%)] (P <0.01). The incidence of urinary incontinence at 1 month after surgery was the lowest in premenopausal group and late menopause Group was the highest, the difference between the two groups was statistically significant (P <0.05). Conclusion: Hysterectomy has some effect on urinary system and intestinal function in women, especially for postmenopausal women.