盆底重建术后盆底肌肉功能评估的前瞻性研究

发布时间：2018-11-10 09:35

【摘要】：目的探讨自身组织修复和网片置入两种盆底重建术后盆底肌肉的功能及术后生活质量。方法选取2013年9月至2016年9月于北京协和医院行盆底重建手术,并于2014年9月至2016年12月门诊随访患者共130例。以是否放置网片将患者分为网片组及自身组织修复组,以随访时间不同分为术后3个月随访组及术后1年随访组,在术后3个月及术后1年对其进行盆底肌肉功能评估和生活质量、性生活质量的评估。结果不同术式组、不同随访时间组术后盆底肌力差异无统计学意义(P0.05)。不同术式患者阴道动态压力及生活质量评分差异均有统计学意义(P=0.005,P=0.037),网片组优于自身组织修复组。不同术式阴道动态压力与POP-Q分度各指示点仅网片组与Aa点(P=0.029)、Ba点(P=0.031)相关,盆底Ⅱ类肌肌力与Bp点(P=0.041)相关,网片组术后3个月随访患者盆底Ⅰ类肌力与Aa点(P=0.026)、Ba点(P=0.038)、C点(P=0.038)相关,盆底Ⅱ类肌力与Aa点(P=0.049)、Ba点(P=0.025)、C点(P=0.011)、Ap点(P=0.032)、Bp点(P=0.05)相关;术后1年随访患者盆底Ⅰ类肌力与Aa点(P=0.015)、Ba(P=0.037)相关。结论网片置入盆底重建手术不影响患者盆底肌肉功能,盆底重建术可改善盆底功能。经盆底肌肉功能锻炼是否可加强盆底重建术后患者盆底肌肉功能需进一步研究。
[Abstract]:Objective to investigate the function and quality of life of pelvic floor muscles after pelvic floor reconstruction. Methods pelvic floor reconstruction was performed from September 2013 to September 2016, and 130 outpatients were followed up from September 2014 to December 2016. The patients were divided into the mesh group and the self-tissue repair group according to whether the mesh was placed or not. The patients were divided into 3 months follow-up group and 1 year follow-up group according to the follow-up time. The pelvic floor muscle function, quality of life and sexual life were evaluated 3 months after operation and 1 year after operation. Results there was no significant difference in pelvic floor muscle strength between different operation groups and different follow-up time groups (P0.05). There were significant differences in vaginal dynamic pressure and quality of life (P0. 005, P0. 037) in patients with different types of operation, and the mesh group was superior to the self-repairing group. The dynamic pressure of vagina and the POP-Q index were correlated with the Aa point (P0. 029), Ba point) and the pelvic floor type 鈪，

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