改良盆底重建术与阴道壁桥式修补术在治疗女性盆腔脏器脱垂中的应用

doi:10.3877/cma.j.issn.1673-5250.2011.06.012

目的

探讨改良盆底重建术和阴道壁桥式修补术治疗盆腔脏器脱垂(POP)的临床效果。

方法

选择2009年1月至2010年12月在本院妇科行手术治疗的50例POP患者为研究对象。按照不同手术方式将其随机分为研究组(n＝25，接受改良盆底重建术)和对照组(n＝25，接受阴道壁桥式修补术)，两组患者均根据自身情况决定保留或不保留子宫。评价两种术式的治疗效果(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准，分组征得受试对象本人的知情同意，并与之签署临床研究知情同意书)。两组患者年龄、体重指数(BMI)及盆腔脏器脱垂定量(POP－Q)等比较，差异无统计学意义(P>0.05)。

结果

①两组手术平均时间比较，差异无统计学意义(P>0.05); ② 研究组术中平均出血量略多于对照组，但差异无统计学意义(P>0.05)；③研究组平均住院时间明显短于对照组，两组比较，差异有统计学意义(P<0.01)；④术后对照组阴道长度较术前明显缩短，组内比较，差异有统计学意义(P<0.05)；研究组术后阴道长度则较术前无明显变化，组内比较，差异无统计学意义(P>0.05)。两组术后阴道长度比较，差异有统计学意义(P<0.05)；⑤研究组随访(6~30个月)未发现复发患者，对照组中2例复发；⑥研究组患者行改良盆底重建术后对性生活影响较小，与对照组比较，差异有统计学意义(P<0.001)。

结论

改良盆底重建术是治疗POP的有效术式，手术简单、安全且微创。

关键词: 盆腔脏器脱垂, 盆底重建, 网片

Objective

To investigate clinical results of improved pelvic floor reconstruction and vaginal paravaginal repair plus vaginal bridge repair in the treatment of female pelvic organ prolapse (POP).

Methods

From January 2009 to December 2010, a total of 50 women with POP were included into this study. They were divided into two groups randomly according to different operation methods, study group (n=25) received improved pelvic floor reconstruction and control group (n=25) received vaginal paravaginal repair plus vaginal bridge repair. Informed consent was obtained from all participates. There had no significant difference between two groups among ages, body mass index (BMI), parities, length of vagina and POP quantitative examination(POP-Q)(P>0.05).

Results

① No significant difference was found of average operation time between two groups (P>0.05). ② The blood bleeding volume during operation in study group was slightly more than that in control group with no significant difference (P>0.05). ③ The average length of stay in study group was significantly shorter than that in control group (P<0.01). ④ Vaginal length after the operation was significantly shorter than that before operation in control group, but no difference was found in study group before and after the operation. There had significant difference of vaginal length between study and control group (P<0.05). ⑤ No recurrence was found in study group in follow-up, there had two cases in control group. ⑥ The study group had less impact on postoperative sexual life than that of control group (P<0.001).

Conclusion

The improved pelvic floor reconstruction is an effective surgical method in the treatment of female POP, which can strengthen the pelvic organ.

Key words: pelvic organ prolapse, improved pelvic floor reconstruction, mesh

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Improved Pelvic Floor Reconstruction and Vaginal Paravaginal Repair Plus Vaginal Bridge Repair in the Treatment of Female Pelvic Organ Prolapse

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Improved Pelvic Floor Reconstruction and Vaginal Paravaginal Repair Plus Vaginal Bridge Repair in the Treatment of Female Pelvic Organ Prolapse