摘要
目的探讨宫颈癌广泛性子宫切除术后高压氧治疗对患者膀胱功能的影响。方法选取2020年1月至2021年6月青岛大学附属烟台毓璜顶医院妇科收治的100例宫颈癌行广泛性子宫切除术患者作为研究对象, 按照随机数字表法分为高压氧组与对照组, 每组50例。对照组患者行常规治疗, 高压氧组患者在此基础上联合高压氧治疗。观察2组患者的首次拔管失败率、首次拔管失败患者的残余尿量、反复拔管次数、导尿管留置时间、尿潴留及尿路感染发生率及尿流动力学的变化。结果高压氧组患者的首次拔管失败率为46%, 低于对照组(58%), 但差异无统计学意义(P>0.05)。高压氧组首次拔管失败患者的残余尿量为(279.79±122.48)ml, 较对照组[(378.27±174.79)ml]明显减少;高压氧组患者反复拔管的次数为(2.57±0.79)次, 较对照组[(3.29±1.08)次]明显减少;导尿管留置时间为(18.50±4.29)d, 较对照组[(22.18±5.23)d]明显缩短;尿潴留及尿路感染发生率为12%、4%, 较对照组(28%、18%)明显降低, 差异均有统计学意义(P<0.05)。高压氧组患者术后膀胱初感容量为(143.34±10.99)ml, 较对照组[(150.52±22.33)ml]明显减少;术后膀胱最大容量为(377.06±27.68)ml, 较对照组[(397.16±39.82)ml]明显减少;术后膀胱顺应性为(48.10±9.74)ml/cm H_(2)O, 较对照组[(43.60±9.41)ml/cm H_(2)O]明显增加;术后最大尿流率为(15.64±1.89)ml/s, 较对照组[(13.96±1.94)ml/s]明显增加;术后最大尿流率时逼尿肌压力为(33.54±2.70)cmH_(2)O, 较对照组[(29.64±4.71)cmH_(2)O]明显增加, 差异均有统计学意义(P<0.05、P<0.01或P<0.001)。结论宫颈癌行广泛性子宫切除术后行高压氧治疗可以有效改善患者的尿流动力学, 改善膀胱功能, 减少反复拔管次数、缩短导尿管留置时间, 降低尿潴留的发生率。
Objective To investigate the effect of hyperbaric oxygen(HBO)on bladder function after extensive hysterectomy for cervical cancer.Methods A total of 100 patients with cervical cancer who underwent extensive hysterectomy in the department of gynecology of Yantai Yuhuangding Hospital from January 2020 to June 2021 were selected as the research subjects.They were randomly divided into HBO group(n=50)and control group(n=50),according to the random number table method.The control group was given conventional treatment,while the HBO group was treated with HBO on the basis of the treatment in the control group.The failure rate of the first catheter removal,residual urine volume after the first failed catheter removal,repeated catheter removal attempts,duration of indwelling urinary catheter,incidences of urinary retention and urinary tract infection,and the urodynamic changes were observed.Results The failure rate of the first catheter removal in the HBO group(46%)was lower than that in the control group(58%),but the difference was not statistically significant(P>0.05).The residual urine volume after the first failed catheter removal in the HBO group was significantly lower than that in the control group[(279.79±122.48)ml<(378.27±174.79)ml];the number of repeated catheter removal attempts in the HBO group was significantly lower than that in the control group[(2.57±0.79)times<(3.29±1.08)times];the duration of indwelling urinary catheter in the HBO group was significantly shorter than that in the control group[(18.50±4.29)d<(22.18±5.23)d];and the incidences of urinary retention and urinary tract infection in the HBO group were significantly lower than those in the control group(12%<28%,and 4%<18%,respectively);all the differences were statistically significant(P<0.05).The postoperative bladder initial sensory capacity in the HBO group was significantly lower than that in control group[(143.34±10.99)ml<(150.52±22.33)ml];the maximum postoperative bladder capacity in the HBO group was significantly lower than that in the control group[(377.06±27.68)ml<(397.16±39.82 ml)];the postoperative bladder compliance in the HBO group was significantly higher than that of the control group[(48.10±9.74)ml/cm H_(2)O<(43.60±9.41)ml/cm H_(2)O];the maximum postoperative urinary flow rate in the HBO group was significantly higher than that of the control group[(15.64±1.89)ml/s>(13.96±1.94)]ml/s];and the detrusor pressure at the maximum urinary flow rate in the HBO group was significantly higher than that in the control group[(33.54±2.70)cm H_(2)O>(29.64±4.71)cm H_(2)O];all the differences were statistically significant(P<0.05 or P<0.01 or P<0.001).Conclusion HBO therapy after extensive hysterectomy for cervical cancer can effectively improve urodynamics,enhance the bladder function,and reduce the attempts of repeated catheter removal,the duration of indwelling urinary catheter,and the incidence of urinary retention.
作者
曹春妮
王秀丽
姜学强
王有存
张敏
Cao Chunni;Wang Xiuli;Jiang Xueqiang;Wang Youcun;Zhang Min(Department of Hyperbaric Oxygen Therapy,Yantai Yuhuangding Hospital Affiliated to Qingdao University,Yantai 264000,China;Department of Gynecology,Yantai Yuhuangding Hospital Affiliated to Qingdao University,Yantai 264000,China;Department of Hyperbaric Oxygen Therapy,PLA No.960 Hospital,Jinan 250031,China;Intensive Care Unit,Department of Neurology,Yantai Yuhuangding Hospital Affiliated to Qingdao University,Yantai 264000,China)
出处
《中华航海医学与高气压医学杂志》
CAS
CSCD
2023年第6期789-793,共5页
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
关键词
宫颈癌
广泛性子宫切除术
高压氧
尿潴留
尿路感染
尿流动力学
Cervical cancer
Extensive hysterectomy
Hyperbaric oxygen
Urinary retention
Urinary tract infection
Urodynamics
作者简介
通信作者:张敏,Email:420076234@qq.com。
