阴道前后壁修补联合补片在女性盆底重建手术中的应用  

Anterior and/or posterior colporrhaphy plus mesh in female pelvic floor reconstructive surgery

作　　者：杜培[1] 张晓薇[1] 陈日笑[1] 

机构地区：[1]广州医学院第一附属医院妇产科,510120

出　　处：《实用医学杂志》2008年第9期1522-1525,共4页The Journal of Practical Medicine

摘　　要：目的:探讨阴道前后壁修补联合补片在盆底重建手术中应用的有效性和安全性。方法:对23例患有不同程度盆底功能障碍性疾病患者采用阴道前后壁修补联合补片的手术治疗方式。结果:23例患者均顺利完成手术,无发生血肿,无尿道、膀胱及直肠损伤。手术平均时间为139.23min,术中平均出血161.43mL,平均住院时间为8.6d。23例患者中,术后6个月～1.8年内出现3例补片侵蚀,1例为前壁补片,2例为后壁补片,发生侵蚀的平均时间为9.6个月,无发生补片感染。随访期间1例前壁补片侵蚀患者出现阴道前壁Ⅰ度膨出。12例合并压力性尿失禁的患者,术后尿失禁现象均得到有效控制,残余尿<50mL,主观排尿症状改善达到100%,随访期间未发现复发现象。结论:阴道前后壁修补联合应用补片并发症少、患者耐受性好、治愈率高、近期效果满意,在盆底重建手术中具有一定的积极意义,是值得临床推广的盆底障碍疾病治疗方法。Objective To investigate the effectiveness and safety of anterior and/or posterior colpon-haphy plus mesh in pelvic floor reconstructive surgery. Methods 23 patients with different pelvic floor dysfunction underwent single or mixed anterior or posterior vaginal wall repair plus mesh. Results The procedures were successfully performed in all the patients and no complications including bladder, urinary, or rectum injury or hematocele occurred. Duration of surgery was 139.23 min, average volume of intraoperative bleeding was 161.43 mL, and average length of hospital stay was 8.6 days. 3 of 23 cases occurred mesh erosion 6 to 20 months after operation, one being in the anterior vaginal wall and two in the posterior wall. No mesh-induced infection was found. One patient with mesh erosion in the anterior vaginal wall occurred stage I anterior colpocele. Stress urinary incontinence was postoperatively controlled in 12 patients, residue urine becoming less than 50 mL. No recurrence occurred during follow-up. Conclusions Anterior and/or posterior colporrhaphy plus mesh can be well tolerated and has a satisfactory short-term effect but fewer complications. It is worth to be popularized in the treatment of female pelvic floor dysfunction.

关 键 词：修复外科手术 补片 盆底重建 经阴道吊带悬吊术 

分 类 号：R713[医药卫生—妇产科学]