西宁地区女性盆底功能障碍性疾病的术后疗效评价
发布时间：2018-10-12 17:10
【摘要】：研究目的：比较阴式子宫全切除术+阴道前后壁修补术和Surgimesh盆底重建术在治疗女性盆底功能障碍中的临床疗效及对患者术后生活质量的影响。 资料与方法：收集2009年11月-2012年01月青海大学附属医院妇科93例诊断为女性盆底功能障碍的患者，根据手术方式不同，分为研究组和对照组，研究组为Surgimesh盆底重建术患者51例，对照组为阴式子宫全切除术+阴道前后壁修补术患者42例，两组患者的年龄、体重指数、孕次、产次等一般临床资料无统计学差异（P0.05），对比两组患者的治愈率评价手术效果，并对两组患者术前、术后的盆底功能影响问卷（PFIQ-7）、盆底功能障碍问卷（PFDI-20）进行调查，评价其术后生活质量。 结果：1、研究组平均手术时间为108.3±29.4min，平均术中出血量为192.3±72.9ml，平均保留尿管时间为3.8±1.1d，平均术后住院时间为7.1±1.5d，对照组平均手术时间为127.0±18.5min，平均术中出血量为251.4±56.2ml，平均保留尿管时间为3.6±0.7d，平均术后住院时间为9.0±2.4d，比较两组以上指标，在平均手术时间、平均术中出血量和平均术后住院时间上具有统计学差异（P0.05）；在平均保留尿管时间上没有差异（P0.05）。2、手术疗效研究组的随访率100%，对照组术后6个月、1年、2年的随访率分别为100%（42/42），95.24%（40/42），92.86%（39/42）。在术后6个月随访，研究组100%（51/51）治愈率高于对照组治愈率95.24%（40/42），但是没有统计学差异（2=2.482，P=0.115）；术后1年和术后2年随访，研究组的治愈率均高于对照组，并且差异具有统计学意义（P0.05）。3、术后评分情况两组患者术后PFIQ-7和PFDI-20评分较术前均有显著性下降（P0.05）。但研究组术后6个月、1年和2年PFIQ-7、PFDI-20评分均低于同期对照组（P0.05）。 结论：1、Surgimesh盆底重建术临床疗效显著，达到预期的效果，对提高患者的生活质量有较大帮助。2、Surgimesh盆底重建术的治愈率较阴式子宫全切除术+阴道前后壁修补术高，术后生活质量的改善更好，，但远期疗效仍需进一步随访。
[Abstract]:Objective: to compare the clinical effect of vaginal anterior and posterior wall repair and Surgimesh pelvic floor reconstruction in the treatment of female pelvic floor dysfunction. Materials and methods: from November 2009 to January 2012, 93 patients with pelvic floor dysfunction diagnosed by gynecology of affiliated Hospital of Qinghai University were divided into study group and control group according to the different operation methods. 51 patients with Surgimesh pelvic floor reconstruction were enrolled in the study group. The control group was 42 patients with vaginal wall repair after vaginal hysterectomy. There was no significant difference in age, body mass index, pregnancy, labor and other general clinical data between the two groups (P0.05). The curative rate of the two groups was compared to evaluate the effect of operation. The preoperative and postoperative pelvic floor impact questionnaire (PFIQ-7) and pelvic floor dysfunction questionnaire (PFDI-20) were investigated to evaluate the postoperative quality of life. Results: 1. The average operative time, mean intraoperative bleeding, retention time and hospitalization time were 108.3 卤29.4 min, 192.3 卤72.9 ml, 3.8 卤1.1 d, 7.1 卤1.5 d, 127.0 卤18.5 min, 251.4 卤56.2 ml, and mean catheter retention time, respectively, in the study group (108.3 卤29.4 min), in the control group (127.0 卤18.5 min), in the average intraoperative bleeding volume (251.4 卤56.2 ml), and in the retention of urinary catheter. The mean hospitalization time was 9.0 卤2.4 days and 3.6 卤0.7 days. The above indexes were compared between the two groups. There were significant differences in average operative time, average intraoperative bleeding volume and average postoperative hospitalization time (P0.05). There was no difference in the mean retention time of urinary catheter (P0.05). The follow-up rate of the study group was 100%. The follow-up rates of the control group were 100% (42 / 42), 95.24% (40 / 42) and 92.86% (39 / 42) respectively at 6 months, 1 year and 2 years after operation. After 6 months follow-up, the cure rate in the study group was 100% (51 / 51) higher than that in the control group 95.24% (40 / 42), but there was no statistical difference (22.482P 0.115), and the cure rate in the study group was higher than that in the control group after 1 and 2 years follow-up. And the difference was statistically significant (P0.05). The postoperative scores of two groups of patients after PFIQ-7 and PFDI-20 scores were significantly lower than before (P0.05). However, the PFIQ-7,PFDI-20 scores in the study group at 6 months, 1 year and 2 years were lower than those in the control group (P0.05). Conclusion: (1) Surgimesh pelvic floor reconstruction has a significant clinical effect, achieves the desired effect, and is of great help to improve the quality of life of the patients. 2 Surgimesh pelvic floor reconstruction has a higher cure rate than that of vaginal wall repair after vaginal hysterectomy. The improvement of quality of life after operation is better, but the long-term effect still needs further follow-up.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R713
本文编号：2266919
[Abstract]:Objective: to compare the clinical effect of vaginal anterior and posterior wall repair and Surgimesh pelvic floor reconstruction in the treatment of female pelvic floor dysfunction. Materials and methods: from November 2009 to January 2012, 93 patients with pelvic floor dysfunction diagnosed by gynecology of affiliated Hospital of Qinghai University were divided into study group and control group according to the different operation methods. 51 patients with Surgimesh pelvic floor reconstruction were enrolled in the study group. The control group was 42 patients with vaginal wall repair after vaginal hysterectomy. There was no significant difference in age, body mass index, pregnancy, labor and other general clinical data between the two groups (P0.05). The curative rate of the two groups was compared to evaluate the effect of operation. The preoperative and postoperative pelvic floor impact questionnaire (PFIQ-7) and pelvic floor dysfunction questionnaire (PFDI-20) were investigated to evaluate the postoperative quality of life. Results: 1. The average operative time, mean intraoperative bleeding, retention time and hospitalization time were 108.3 卤29.4 min, 192.3 卤72.9 ml, 3.8 卤1.1 d, 7.1 卤1.5 d, 127.0 卤18.5 min, 251.4 卤56.2 ml, and mean catheter retention time, respectively, in the study group (108.3 卤29.4 min), in the control group (127.0 卤18.5 min), in the average intraoperative bleeding volume (251.4 卤56.2 ml), and in the retention of urinary catheter. The mean hospitalization time was 9.0 卤2.4 days and 3.6 卤0.7 days. The above indexes were compared between the two groups. There were significant differences in average operative time, average intraoperative bleeding volume and average postoperative hospitalization time (P0.05). There was no difference in the mean retention time of urinary catheter (P0.05). The follow-up rate of the study group was 100%. The follow-up rates of the control group were 100% (42 / 42), 95.24% (40 / 42) and 92.86% (39 / 42) respectively at 6 months, 1 year and 2 years after operation. After 6 months follow-up, the cure rate in the study group was 100% (51 / 51) higher than that in the control group 95.24% (40 / 42), but there was no statistical difference (22.482P 0.115), and the cure rate in the study group was higher than that in the control group after 1 and 2 years follow-up. And the difference was statistically significant (P0.05). The postoperative scores of two groups of patients after PFIQ-7 and PFDI-20 scores were significantly lower than before (P0.05). However, the PFIQ-7,PFDI-20 scores in the study group at 6 months, 1 year and 2 years were lower than those in the control group (P0.05). Conclusion: (1) Surgimesh pelvic floor reconstruction has a significant clinical effect, achieves the desired effect, and is of great help to improve the quality of life of the patients. 2 Surgimesh pelvic floor reconstruction has a higher cure rate than that of vaginal wall repair after vaginal hysterectomy. The improvement of quality of life after operation is better, but the long-term effect still needs further follow-up.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R713
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