经阴道植入网片全盆底重建术治疗女性盆腔脏器脱垂的临床研究

发布时间：2018-01-20 02:53

  本文关键词： 盆腔器官脱垂 Prolift全盆底重建术 网片 子宫切除术 阴道式　出处：《山东大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的 探讨经阴道植入网片Prolift全盆底重建术和TVH+阴道前后壁修补术治疗盆腔脏器脱垂性疾病的临床意义。 方法 回顾分析2006年2月～2014年6月山东省立医院40例盆腔脏器脱垂(POP)患者行Prolift全盆底重建术(研究组)或TVH+阴道前后壁修补术(对照组)的疗效及并发症情况。根据术式分为两组,其中研究组20例,包括研究1组TVH+Prolift全盆底重建术3例,研究2组单行Prolift全盆底重建术17例：对照组20例,行传统的TVH+阴道前后壁修补术,并评价两组术后1年内各项客观和主观指标。 结果 (1)两组患者的临床资料包括年龄、绝经情况、体重指数、分娩方式、孕次、产次、两组患者的POP-Q量化分度及术后持续导尿时间均无统计学差异(P0.05)。 (2)手术时间、术中出血量、平均住院时间研究2组与对照组有显著差异,手术时间明显缩短,术中出血量明显减少,平均住院时间减少(P0.05),研究1组与对照组无明显差异(P0.05)。 (3)术后临床疗效比较：两组患者出院前测评POP-Q,分度均为0度或Ⅰ度。以P-QOL量表评分作为主观疗效评价指标,主观满意度均达100%。 (4)随访：术后平均随访一年,对照组随访率95%,研究组随访率100%。POP-Q分度Ⅱ度及Ⅱ度以上判定为复发,对照组1例复发,复发率为5%,研究组无1例复发(P0.05)。 结论 (1)TVH+阴道前后壁修补术和Prolift全盆底重建术均是治疗POP安全有效的方法。 (2) Prolift全盆底重建术作为一种新术式,手术操作安全、创伤小、并发症少,能更好地修补缺陷、重建盆底结构、恢复盆底功能,且复发率低,短期疗效稳定,长期疗效有待进一步随访观察。
[Abstract]:Purpose To investigate the clinical significance of Prolift total pelvic floor reconstruction and TVH vaginal anterior and posterior wall repair in the treatment of pelvic visceral prolapse. Method A retrospective analysis of 40 patients with pelvic organ prolapse (POP) in Shandong Provincial Hospital from February 2006 to June 2014 was performed with Prolift total pelvic floor reconstruction (study group). Or TVH anterior and posterior wall repair (control group), the curative effect and complications were divided into two groups according to the operation method. There were 20 cases in study group, including 3 cases of TVH Prolift total pelvic floor reconstruction in group 1, 17 cases of Prolift total pelvic floor reconstruction in 2 groups and 20 cases in control group. Traditional TVH anterior and posterior wall repair was performed, and objective and subjective indexes were evaluated in both groups within 1 year after operation. Results The clinical data of the two groups included age, menopause, body mass index, mode of delivery, pregnancy and delivery. There was no significant difference in POP-Q quantification and duration of urinary catheterization between the two groups (P 0.05). (2) the operative time, intraoperative bleeding volume, average hospitalization time were significantly different between the two groups, the operative time was shortened, the intraoperative bleeding volume was significantly reduced, and the average hospitalization time was decreased (P 0.05). There was no significant difference between group 1 and control group (P 0.05). (3) comparison of postoperative clinical efficacy: POP-Qs were measured by 0 degree or 1 degree before discharge in both groups. P-QOL score was taken as subjective evaluation index. Subjective satisfaction was 100. (4) Follow-up: the average follow-up rate was one year after operation. The follow-up rate of the control group was 95. The follow-up rate of the study group was 100. POP-Q grade 鈪，

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