Department of Human Metabolism, Academic Unit of Reproductive and Developmental Medicine, University of Sheffield, UK.
Eur J Gastroenterol Hepatol. 2013 Oct;25(10):1217-22. doi: 10.1097/MEG.0b013e328362dc5e.
On the basis of retrospective studies, hysterectomy has been considered a risk factor for functional bowel disorders. The aim of this study was to prospectively evaluate the patients' bowel function and general health-related quality of life (QoL) before and after hysterectomy. Our hypothesis was that hysterectomy in properly selected patients can impact positively on the patients' self-reporting of their general health and bowel function.
A prospective longitudinal observational study was conducted in a university-based teaching hospital. Eighty-five patients who were scheduled for total abdominal hysterectomy for a nonmalignant cause completed the study. The main outcome measure was the patient's perception of her bowel function, which was assessed preoperatively and at 6, 12, 26 and 52 weeks postoperatively using the gastrointestinal quality of life questionnaire. The patient's general health was also assessed using a generic general health questionnaire (EQ5D and EQVAS). The effect of time on change in questionnaire score was assessed using mixed model repeated measures at a significance level of 0.05.
The scores in the three questionnaires declined significantly at 6 weeks postoperatively as compared with those obtained preoperatively. However, there was a subsequent increase in the scores up to 12 months postoperatively. Smoking and use of laxative were identified as potential confounding variables.
Apart from a transient negative effect, total abdominal hysterectomy improves the patient's gastrointestinal-related QoL, probably as part of general improvement in their QoL.
基于回顾性研究，子宫切除术已被认为是功能性肠病的一个危险因素。本研究旨在前瞻性评估子宫切除术前和术后患者的肠道功能和与健康相关的总体生活质量（QoL）。我们的假设是，在适当选择的患者中进行子宫切除术可以对患者自我报告的总体健康和肠道功能产生积极影响。
在一家大学附属医院进行了一项前瞻性纵向观察性研究。85 名因非恶性原因接受全腹部子宫切除术的患者完成了这项研究。主要观察指标是患者对肠道功能的感知，术前和术后 6、12、26 和 52 周使用胃肠道生活质量问卷进行评估。患者的一般健康状况也使用通用一般健康问卷（EQ5D 和 EQVAS）进行评估。使用混合模型重复测量，在 0.05 的显著性水平上评估时间对问卷评分变化的影响。
与术前相比，术后 6 周时三个问卷的评分显著下降。然而，术后 12 个月后评分又有所增加。吸烟和使用泻药被确定为潜在的混杂变量。
除了短暂的负面影响外，全腹部子宫切除术还可以改善患者的胃肠道相关 QoL，这可能是其总体 QoL 改善的一部分。
