改良盆底重建术治疗盆腔器官脱垂的临床研究

发布时间：2018-09-18 15:50

【摘要】：目的:探讨改良盆底重建术治疗盆腔器官脱垂(POP)的临床实用性。方法:选取59例POP患者,其中19例采用改良盆底重建术(A组),20例采用阴式子宫全切除术+阴道前壁"斜拉桥"式修补术(B组);20例采用传统阴式子宫全切除术+阴道前壁修补术(C组)。比较3组患者的围手术期各项指标情况及术后复发、阴道深度、性生活保持情况及疼痛不适等并发症情况。结果:(1)3组患者的手术时间、术中出血量、术后病率、术后性生活保持率及术后随访主观复发率比较差异均无统计学意义(P0.05);3组的术后留置尿管时间及客观复发率两两比较差异均有统计学意义(P0.05),A组的留置尿管时间最短,C组的客观复发率较高。C组术后的平均阴道深度浅于A、B组,差异有统计学意义(P=0.000);但后两组比较差异无统计学意义。3组患者均无严重并发症发生。结论:3种术式均能短期内解决POP问题,改良盆底重建术术式简单易操作,可保持盆底结构及功能的完整性,短期内具有较好的疗效,但远期疗效尚待循证。
[Abstract]:Objective: to investigate the clinical practicability of modified pelvic floor reconstruction in the treatment of pelvic organ prolapse (POP). Methods: 59 patients with POP were selected. Among them, 19 cases were treated with modified pelvic floor reconstruction (group A) and 20 cases were treated with vaginal anterior wall repair (group B), 20 cases with traditional vaginal hysterectomy (group C). The perioperative indexes, postoperative recurrence, vaginal depth, sex life, pain and discomfort were compared among the three groups. Results: (1) the time of operation, the amount of blood lost during operation, the rate of disease after operation, There was no significant difference between the retention rate of postoperative sexual life and the subjective recurrence rate of postoperative follow-up (P0.05) the time of indwelling urethral catheter and the objective recurrence rate of three groups were significantly different (P0.05) the time of indwelling urethral catheter in group A was the shortest. The objective recurrence rate in group C was higher than that in group A. the average depth of vagina in group C was lighter than that in group A (P < 0.05). The difference was statistically significant (P < 0. 000), but there was no significant difference between the latter two groups. Conclusion all three methods can solve the POP problem in a short time. The modified pelvic floor reconstruction is simple and easy to operate and can maintain the integrity of the structure and function of the pelvic floor. It has a good effect in the short term, but the long-term effect remains to be documented.
【作者单位】：温州医科大学;桐乡市第一人民医院;温州医科大学附属第一医院;
【分类号】：R713

【参考文献】