盆底康复训练对宫颈癌术后膀胱功能恢复及减少尿潴留的临床效果

目的:探讨盆底康复训练对宫颈癌术后膀胱功能恢复及减少尿潴留的临床效果。方法:选取2018年01月至2019年04月我院收治的86例行宫颈癌根治术的患者进行研究。按照随机数表法分为观察组和对照组各43例，对照组给予常规术后护理干预，观察组在对照组的基础上增加盆底康复训练干预。对比两组围手术期指标、膀胱功能恢复情况、尿潴留发生率及尿动力学指标；并于术前，术后1月、6月、12月评估两组PFIQ-7、PFDI-20评分。结果:观察组尿管留置时间、首次自主排尿时间、下床活动时间、首次进食时间、肛门排气时间及住院时间均优于对照组（P＜0.05）。观察组膀胱功能恢复良好率高于对照组，膀胱复原时间、拔除尿管残余尿量及尿潴留发生率优于对照组（P＜0.05）。治疗后2周，观察组膀胱逼尿肌收缩压、膀胱顺应性明显高于对照组（P＜0.05），尿道闭合压两组未见统计学差异（P＞0.05）。术后1月、6月、12月观察组PFIQ-7、PFDI-20评分始终低于对照组（P＜0.05）。结论:宫颈癌根治术后采用生物反馈电刺激联合凯格尔训练等盆底康复治疗可有效降低宫颈癌患者术后尿潴留发生风险，改善盆底功能障碍及尿动力学指标，加快术后排尿，利于膀胱功能的恢复。

Clinical effect of pelvic floor rehabilitation training on recovery of bladder function and reduction of urinary retention after cervical cancer surgery

Objective:To explore the clinical effect of pelvic floor rehabilitation on the recovery of bladder function and urinary retention after cervical cancer surgery.Methods:A total of 86 cervical cancer patients admitted to our hospital from January 2018 to April 2019 for radical resection of cervical cancer were selected.According to the random number table,all the patients were divided into observation group and control group,with 43 cases each.The control group received routine postoperative care,and the observation group increased pelvic floor rehabilitation therapy on the basis of routine postoperative care in the control group.Perioperative indicators,recovery of bladder function,incidence of urinary retention and urodynamic indicators were compared between the two groups.The PFIQ-7 and PFDI-20 scores of the two groups were evaluated at 1 month,6 months and 12 months before and after surgery.Results:The observation group had better urinary indwelling time,first voluntary urination time,out of bed activity time,first feeding time,anal discharge time and hospital stay time than the control group(P＜0.05).The recovery rate of bladder function in the observation group was higher than that in the control group,and the time of bladder recovery,residual urine volume and incidence of urinary retention were better than those in the control group(P＜0.05).Two weeks after treatment,the detrusor systolic pressure and bladder compliance of the observation group were significantly higher than those of the control group(P＜0.05),and there was no statistical difference in urethral closure pressure between the two groups(P＞0.05).The PFIQ-7 and PFDI-20 scores of the observation group were always lower than those of the control group at 1 month,6 months and 12 months after operation(P＜0.05).Conclusion:After radical resection of cervical cancer,biofeedback electric stimulation combined with Kegel training and other pelvic floor rehabilitation treatments can effectively reduce the risk of postoperative urinary retention in patients with cervical cancer,improve pelvic floor dysfunction and urodynamic indicators,accelerate postoperative urination,and benefit the recovery of bladder function.