Li Xichun, Liu Ling, He Jinhui, Yan Jue, Wang Ying
Department of Rehabilitation, Chengfei Hospital, Chengdu, China.
Department of Rehabilitation, Bayi Orthopaedic Hospital, Chengdu, China.
Front Oncol. 2023 May 9;13:1118794. doi: 10.3389/fonc.2023.1118794. eCollection 2023.
To analyze the application effect of pelvic floor rehabilitation exercise in postoperative patients with cervical cancer and the factors influencing their self-efficacy.
120 postoperative patients with cervical cancer from January 2019 to January 2022 from the Department of Rehabilitation, Aeronautical Industry Flying Hospital, Bayi Orthopaedic Hospital and Southwest Medical University Affiliated Hospital of Traditional Chinese Medicine, and the Department of Obstetrics and Gynecology, Chengdu Seventh People's Hospital, and the Department of Oncology, Sichuan Provincial People's Hospital were selected for the study. They were divided into routine group (n=44, applied routine care) and exercise group (n=76, applied routine care + pelvic floor rehabilitation exercise) according to the different perioperative care programs. The perioperative indicators, bladder function recovery rate and urinary retention incidence, urodynamic indicators, and pelvic floor distress inventory-short form 20 (PFDI-20) scores were compared between the 2 groups. The general data, PFDI-20 scores and broome pelvic muscle self-efficacy scale (BPMSES) scores of patients in the exercise group were investigated and analyzed individually to investigate the factors influencing the self-efficacy of patients with pelvic floor rehabilitation exercise after cervical cancer surgery.
The time of first anal exhaust, urine tube retention and hospitalization after surgery were shorter in the exercise group than in the routine group (P<0.05). The bladder function grade I rate after surgery was more in the exercise group than in the routine group, and the urinary retention incidence was lower than that in the routine group (P<0.05). At 2 weeks after exercise, bladder compliance and bladder detrusor systolic pressure were higher in both groups than before exercise, and they were higher in the exercise group than in the routine group (P<0.05). There was no significant difference in urethral closure pressure within and between the two groups (P>0.05). At 3 months after surgery, the PFDI-20 scores were higher in both groups than before surgery, and the exercise group was lower than the routine group (P<0.05).The BPMSES score for the exercise group was (103.33 ± 9.16). Marital status, residence and PFDI-20 scores were influential factors in the self-efficacy level of patients undergoing pelvic floor rehabilitation exercise after cervical cancer surgery (P<0.05).
Implementing pelvic floor rehabilitation exercise for postoperative patients with cervical cancer can speed up the recovery of pelvic organ function and reduce the occurrence of postoperative urinary retention. Marital status, residence and PFDI-20 scores were influential factors in the self-efficacy level of patients undergoing pelvic floor rehabilitation exercise after cervical cancer surger, medical staff need to incorporate these clinical features to provide targeted nursing interventions to enhance patient compliance with training and improve postoperative survival quality.
分析盆底康复锻炼在宫颈癌术后患者中的应用效果及影响其自我效能感的因素。
选取2019年1月至2022年1月航空工业飞行医院康复科、八一骨科医院、西南医科大学附属中医医院、成都第七人民医院妇产科、四川省人民医院肿瘤科的120例宫颈癌术后患者进行研究。根据围手术期护理方案不同将其分为常规组（n = 44，采用常规护理）和锻炼组（n = 76，采用常规护理 + 盆底康复锻炼）。比较两组的围手术期指标、膀胱功能恢复率及尿潴留发生率、尿动力学指标和盆底困扰量表简表20（PFDI - 20）评分。对锻炼组患者的一般资料、PFDI - 20评分及布鲁姆盆底肌肉自我效能量表（BPMSES）评分进行单因素调查分析，以探究影响宫颈癌术后盆底康复锻炼患者自我效能感的因素。
锻炼组术后首次肛门排气时间、尿管留置时间及住院时间均短于常规组（P < 0.05）。锻炼组术后膀胱功能Ⅰ级率高于常规组，尿潴留发生率低于常规组（P < 0.05）。锻炼2周后，两组膀胱顺应性和膀胱逼尿肌收缩压均高于锻炼前，且锻炼组高于常规组（P < 0.05）。两组组内及组间尿道闭合压比较差异无统计学意义（P > 0.05）。术后3个月，两组PFDI - 20评分均高于术前，且锻炼组低于常规组（P < 0.05）。锻炼组BPMSES评分为（103.33 ± 9.16）。婚姻状况、居住地及PFDI - 20评分是宫颈癌术后盆底康复锻炼患者自我效能水平的影响因素（P < 0.05）。
对宫颈癌术后患者实施盆底康复锻炼可加快盆腔器官功能恢复，降低术后尿潴留的发生。婚姻状况、居住地及PFDI - 20评分是宫颈癌术后盆底康复锻炼患者自我效能水平的影响因素，医护人员需结合这些临床特征提供针对性护理干预，以提高患者训练依从性，改善术后生存质量。
