Prolift网片联合尿道中段悬吊治疗POP或合并SUI患者的近期疗效  

Curative effect of prolift and combining with suspensory midst urethra in surgery therapy on POP or concomitant SUI

作　　者：罗新[1] 王晓玉[1] 沈媛[1] 蒋学风[1] 李瑞满[1] 帅翰林[1] 马雪枫[1] 谢静燕[2] 李玉娟[2] 

机构地区：[1]暨南大学附属第一医院妇产科,广州510630 [2]南京医科大学附属南京第一医院妇产科

出　　处：《现代妇产科进展》2009年第4期289-292,共4页Progress in Obstetrics and Gynecology

基　　金：暨南大学自然科学基金资助项目(No:200351204003);广东省医学科研基金立项课题(No:A2007338);广东省医学科研基金立项课题(No:A2008364);广东省科技计划项目(No:2007B060401054);广东省自然科学基金博士科研启动项目(No:8451063201000190);江苏省卫生厅科研基金项目(No:H200743)

摘　　要：目的:探讨全阴道修复网片(total vaginal mesh,TVM)即Gynecare Prolift网片修复系统及联合经闭孔无张力阴道吊带(tensiongfree vaginal tape-obtutor,TVT-O)尿道中段悬吊手术治疗盆腔器官脱垂(pelvic organ prolapse,POP)或合并压力性尿失禁(stress urinary incontinence,SUI)的近期疗效。方法:选择Ⅱ度以上子宫和(或)阴道壁脱垂患者24例,其中本次手术前已切除子宫5例,术中同时切除子宫12例,保留子宫7例。16例用全盆底修复网片(total Prolift),8例用前盆修复网片(anterior Prolift);10例因合并压力性尿失禁同时行TVT-O尿道中段悬吊术。结果:24例患者术中均无严重并发症发生,3例(12.5%)出血量超过500ml;术后随访12～20个月,1例至术后10个月时发现阴道壁网片侵蚀(4.2%,1/24),经门诊4次修剪好转;24例患者均无复发。结论:用Prolift盆底修复网片系统进行盆底重建术,手术安全、易行、微创,近期疗效肯定;合并SUI者同时使用TVT-O不增加手术难度和并发症的发生率。Objective： To explore the innovative repairing technique and its curative effect of the total vaginal mesh system （ Gynecare Prolift） and combining with suspensory midst urethra （tensiongfree vaginal tape-obtutor,TVT-O） in surgery therapy on pelvic organ prolapse （POP） and concomitant stress urinary incontinence （SUI）. Method：24 cases with stage Ⅱ or more severe genital prolapse on the pelvic organ prolapse quantification examination （POP-Q） were enrolled. 5 in 24 cases had a previous hysterectomy, 12 in 24 cases with transvaginal hysterectomy and 7 in 24 cases preserving uterus. All the 24 cases underwent transvaginal repair by using total vaginal meshes （total Prolift） （16/24） and isolated anterior meshes （anterior Prolift） （8/24） and 10 cases thereinto, who suffered from stress urinary incontinence, with tensionfree vaginal tape-obturator system （TVT-O） procedure simultaneously. Result：There were no severe intraoperative complications in all 24 cases,but 3 cases of them （ 12.5% ） being blood loss more than 500ml. All the cases were followed up for 12 to 20 months. The vaginal wall erosion had been found in one of 24 cases （4.2%） in the 10th months after operation, no severe vaginal infection, recurrent and symptomatic prolapse were occurred in postoperatively shortterm. Conclusion：The total transvaginal mesh system is considered as a safe, simple, mini-invasive, and efficient surgery therapy on POP in short term. The complication and operative difficulty, procedure of Gynecare Prolift and combining it with suspensory midst urethra （tensiongfree vaginal tape-obtutor, TVT-O） ,is not increased for the POP and concomitant SUI. Nevertheless,long-term safety and efficacy should be further observed.

关 键 词：阴道网片 盆底重建 压力性尿失禁 器官脱垂 

分 类 号：R711.5[医药卫生—妇产科学]