改良阴道半封闭术在老年女性盆腔器官脱垂中的应用

发布时间：2018-01-30 19:42

本文关键词： 阴道半封闭术盆腔器官脱垂主客观治愈率　出处：《中国妇产科临床杂志》2015年05期 　论文类型：期刊论文

【摘要】：目的探讨阴道半封闭术在老年盆腔器官脱垂的治疗效果及安全性。方法 2012年11月至2014年2月在甘肃省妇幼保健院妇科,因盆腔器官脱垂实施阴道半封闭术共31例。记录患者的一般资料、脱垂程度、围手术期参数和手术并发症,术后3个月复查,评价主客观治愈率。结果患者平均年龄(72.10±5.58)岁,合并内科疾患者占74.19%(23/31),POP定量分度法(POP-Q)均为Ⅲ~Ⅳ度。手术时间平均(79.81±32.65)min,术中出血量平均(36.77±29.00)ml,术后发热平均(1.52±1.29)d,术后24 h疼痛VAS评分平均(1.53±1.07)分,术后病率发生率12.90%(4/31),术后住院平均(5.74±2.63)d,住院总费用(12918.82±5546.65)元。按术中是否同时行子宫切除术分为两组比较,手术时间、术后VAS评分、术后住院天数、住院总费用、术后病率发生率,两组差异有统计学意义(P0.05);术中出血量、术后发热天数、术前住院天数、术前检查费用,两组比较差异无统计学意义(P0.05)。术后3个月,主观治愈率96.67%,客观治愈率100%。结论阴道半封闭术对于老年重度盆腔器官脱垂是安全有效的,对于术前子宫检查正常的患者是否有必要同时行全子宫切除术是有待商榷的。
[Abstract]:Objective to investigate the efficacy and safety of vaginal semi-sealing in the treatment of pelvic organ prolapse in the elderly. A total of 31 patients underwent vaginal semi-closure for pelvic organ prolapse. The general data, prolapse degree, perioperative parameters and operative complications were recorded and reexamined 3 months after operation. Results the average age of the patients was 72.10 卤5.58 years old. The mean operation time was 79.81 卤32.65 min, and the average intraoperative bleeding was 36.77 卤29.00 ml. The average postoperative fever was 1.52 卤1.29 days, the average VAS score was 1.53 卤1.07 at 24 hours after operation, and the incidence of postoperative disease was 12.90 / 31). The average hospitalization cost was 12918.82 卤5546.65 yuan, and the average hospitalization time was 5.74 卤2.63 days. According to whether the hysterectomy was performed at the same time during the operation, the operation time was compared between the two groups. Postoperative VAS score, postoperative hospitalization days, total cost of hospitalization, incidence of postoperative disease, there was significant difference between the two groups (P 0.05). There was no significant difference between the two groups in blood loss, postoperative fever days, hospitalization days before operation and the cost of preoperative examination. 3 months after operation, the subjective cure rate was 96.67%. Conclusion vaginal semi-sealing is safe and effective for the elderly patients with severe pelvic organ prolapse. The need for simultaneous hysterectomy in patients with normal preoperative uterine examination is open to question.
【作者单位】：甘肃省妇幼保健院;
【分类号】：R713
【正文快照】： 盆腔器官脱垂是中老年妇女的常见疾病,严重影响女性的生活质量。50~79岁的女性发生率为30%~41%[1]。女性一生中因POP行手术的概率为10%~20%[2-3]。目前国内外尚无公认的治疗盆腔器官脱垂的标准术式。阴道封闭术临床应用至今已逾百年。其主要特点是封闭阴道,患者术后失去阴道性

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