经阴网片全盆重建术治疗重度盆腔器官脱垂中长期临床疗效评价

发布时间：2018-02-02 19:23

  本文关键词： 全盆重建术 盆腔器官脱垂　出处：《中国实用妇科与产科杂志》2015年04期 　论文类型：期刊论文

【摘要】：目的探讨经阴网片全盆重建手术治疗盆腔器官脱垂的疗效及并发症,评估该手术的有效性和安全性。方法回顾性分析2007年1月至2014年6月在广州医科大学附属第一医院因盆腔器官脱垂行经阴网片全盆重建术110例患者的临床资料,比较手术前后盆腔器官脱垂定量分期法(POP-Q)各指示点位置,评价总体客观治愈率及复发率。采用盆底功能障碍性疾病症状问卷简表(PFDI-20)等相关问卷评分评价主观治愈率以及术后尿失禁相关症状改善情况。结果 110例患者中失访12例(12/110,10.91%),其中1例因心血管疾病术后1年余死亡,随访98例(98/110,89.09%)。随访时间6~90个月,中位随访时间:48个月。110例患者年龄(65.30±8.00)岁;绝经时间(14.01±9.08)年;采用POP-Q分期评价,术后15例(15/98,15.31%)出现复发,其中11例POP-Q分期Ⅱ期,无主观症状不需再次手术,4例阴道顶端复发(POP-QⅢ期),需再次手术治疗。术后主观治愈率95.92%(94/98),客观治愈率84.69%(83/98);网片挛缩4例(4/98,4.08%),网片外露11例(11/98,11.22%)。术后PFDI-20评分与术前比较,差异有统计学意义(P0.05);术后性生活13例,其中性生活质量5例满意,6例患者较术前差,2例配偶出现性交疼痛;患者总体术后满意度评分满意率95.91%(94/98)。结论经阴网片全盆重建术用于治疗重度盆腔器官脱垂主、客观治愈率高,不仅能达到较好的解剖学复位,对患者的盆腔器官脱垂相关症状有明显改善,术后满意度高且长期疗效稳定,但对性生活质量无明显改善。
[Abstract]:Objective to investigate the curative effect and complications of total pelvic reconstruction with transvaginal mesh in the treatment of pelvic organ prolapse. To evaluate the efficacy and safety of the operation methods from January 2007 to June 2014 in the first affiliated Hospital of Guangzhou Medical University performed total pelvic reconstruction through negative mesh for pelvic organ prolapse: a retrospective analysis of 110 cases. The patient's clinical data. To compare the location of the indicating points of POP-Qs before and after operation by quantitative staging method of pelvic organ prolapse. To evaluate the overall objective cure rate and recurrence rate. A summary table of symptoms of pelvic floor dysfunction (PFDI-20) was used. The subjective cure rate and the improvement of postoperative urinary incontinence symptoms were evaluated by the scores of equal-related questionnaires. Results 12 of 110 patients lost their visits. [WT5HZ] results [WT5BZ] [WT5BZ] [WT5BZ]. One patient died of cardiovascular disease more than one year after operation. 98 cases were followed up for 6 ~ 90 months. Median follow-up time: 48 months. 110 patients were aged 65.30 卤8.00 years. Menopause time was 14.01 卤9.08 years; POP-Q staging was used to evaluate the recurrence in 15 cases (15 / 98 / 15.31). Among them, 11 cases with POP-Q stage 鈪，

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