两种补片在全盆底重建术中应用的比较研究  

Comparison of Prolift system and Gynemesh in total pelvic floor reconstructive surgery

作　　者：张晓红[1] 王红[1] 赵丽君[1] 王建六[1] 

机构地区：[1]北京大学人民医院妇科,100044

出　　处：《中国妇产科临床杂志》2009年第1期5-8,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：卫生部重点学科项目(2007);首都医学发展科研基金项目(2007-2010)资助

摘　　要：目的比较两种补片(Prolift全盆底重建系统和Gynemesh聚丙烯补片)在全盆底重建术的应用情况及近期疗效,探讨更为适宜的全盆底重建手术方式。方法北京大学人民医院妇科在2007年1月～2008年4月间收治因盆腔多个部位缺陷的盆腔脏器脱垂行全盆底重建术患者31例。采用Prolift全盆底重建系统行全盆底重建术14例,Gynemesh聚丙烯补片行全盆底重建术17例。比较两组患者的一般资料、围手术期和随访情况,并进行统计学分析。结果两组的患者体重指数、绝经年龄和孕次比较,差异无显著性(P>0.05),Prolift组平均年龄为(63.29±9.39)岁,小于Gynemesh组的(69.35±5.16)岁(P=0.03)。Prolift组阴道前壁脱垂程度稍重于Gynemesh组(P<0.05)。两组子宫脱垂和阴道后壁脱垂的程度比较,差异无显著性(P>0.05)。两组患者出血量、最高体温、尿管留置天数、术后残余尿和住院时间比较,差异无显著性(P>0.05),手术时间Prolift组短于Gynemesh组(P<0.05)。Prolift组随访率100%,平均随访时间(8.8±3.0)个月,1例(7.1%)术后6个月复查阴道前壁复发I期,1例(7.1%)出现后壁补片侵蚀。Gynemesh组随访率94.1%,平均随访时间(12.4±3.0)个月,4例(23.5%)患者复发,3例(17.6%)患者补片侵蚀。结论Prolift和Gy-nemesh两种补片均可用于全盆底重建,手术均安全可行。在近期疗效和并发症方面,Prolift要优于Gynemesh。Objective To compare the of Prolift system and Gynemesh in total pelvic floor reconstruction ant to explore suitable mesh for total pelvic floor reconstruction. Methods Thirty- one women underwent the surger,. for combined defect of pelvic floor who were admitted to our department from December 2006 to April 2008. The patients were divided into two groups： 14 cases in Gynecare Prolift System surgery and the other 17 in the group o revised total pelvic floor construction with Gynemesh. We compared the pre-, peri - operative data and follow- up results of the two groups were compared, respectively. Results No significant difference was found in the bod： mass index, menopause age and pregnant times between the two groups （P〉0. 05）. The prolapse of anterior vagi nal wall of the Prolift group was severe than Gynemesh group （P〈0. 05）. The operative hemorrhage, the highes body temperature, the residue urine and the time of in - hospital of the two group had no significant difference （P〉0.05）. The operation time ot7 Prolift group was shorter （P〈0. 05） than that of Gynemesh group. Th follow- up rate of the Prolift group was 100%, with mean time of （8.8±3.0） m. Only one case （7. 1%） recurrec with anterior vaginal prolapse in 6 months after operation. One case （7. 1%） occurred erosion in posterior vagina wall. The follow- up rate of the Gyenmesh group was 94%, with mean time of （12. 4±3. 0） mL Four case （23.5%） were recurrence and 3 （17.6%） were found erosion in vaginal wail. Conclusion The Prolift system ant Gynemesh are both safety and feasible. According to the short term clinical outcomes, the Prolift system is little bi better than the Gyenmesh, yet the long term outcomes need further study.

关 键 词：全盆底重建 盆腔器官脱垂 补片 PROLIFT Gynemesh 

分 类 号：R713[医药卫生—妇产科学]