经阴道行阴道旁修补术联合阴道后壁桥式修补术在女性盆腔器官脱垂治疗中的应用  

Vaginal paravaginal repair plus vaginal bridge repair in treatment of female pelvic organ prolapse

作　　者：阮晓红[1] 罗中明[1] 杨爱莲[1] 詹雪梅[1] 练晓勤[1] 温宝宁[1] 容颖柔[1] 甄波[1] 

机构地区：[1]中山大学附属江门医院妇科,529070

出　　处：《中国医师进修杂志》2009年第7期1-4,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨经阴道途径行阴道旁修补（VPVR）术联合阴道后壁桥式修补术在治疗女性盆腔器官脱垂中的有效性和安全性。方法对65例不同程度阴道前壁和，或后壁膨出伴子宫脱垂的患者采用VPVR术联合阴道后壁桥式修补术。术后定期随访，对手术效果进行主观及客观评价，并采用PFDI-20短表进行生活质量调查。结果65例患者均行阴式全子宫切除术及阴道前壁修补术，其中33例行VPVR术，32例行VPVR术联合中央修补术；40例同时行阴道后壁桥式修补术。手术时间（110．00±20．12）min，失血量（119．52±45．33）ml。25例伴有张力性尿失禁的患者术后症状明显改善，除4例术后阴道前壁愈合不良外余无其他手术并发症发生。术后随访6—29个月，主观治愈率92．31％（60／65），客观治愈率100．00％（65／65）。65例患者中58例（89．23％）接受生活质量调查，与术前相比，生活质量明显改善（p〈0．01）。结论VPVR术联合阴道后壁桥式修补术治疗不同程度阴道前壁和／或后壁膨出伴子宫脱垂安全有效，远期疗效尚待进一步观察。Objective To explore the effectiveness and safety of vaginal paravaginal repair（VPVR） plus vaginal bridge repair in the treatment of female pelvic organ prolapse （POP）. Methods Sixty-five patients with different defects of pelvic floor underwent VPVR or plus vaginal bridge repair for posterior vaginal wall. Patients were followed up after operation. The cure rate was estimated subjectively and objectively. The patients＇ quality of life was evaluated by the pelvic floor distress inventory short form 20 （PFDI-20）. Results All 65 cases were treated by vaginal hysterectomy and anterior vaginal repair, in which there were 33 cases underwent VPVR while 32 cases underwent VPVR plus middle area repair. Forty concomitant procedures for vaginal bridge repair were also performed. The average operative time was （ 110.00 ± 20.12） rain and blood loss was （ 119.52± 45.33 ） ml. The symptom of stress urinary incontinence of 25 eases significantly released after operation. Four incision recovery delayed and there were no other complications occurred. Patients were followed up for 6-29 months,the objective cure rate was 100.00% （65/65） and subjective cure rate was 92.31%（60/65）, and 58 eazes （89.23%）improved significantly with the quality of life comparing with that of pre-operation by completing PFDI-20 （P 〈 0.01 ）. Conclusions It is an effective and safe procedure for VPVR plus vaginal bridge repair to correct median to severe anterior vaginal prolapse and posterior vaginal wall prolapse. More clinical trials are needed to evaluate their long-term outcome.

关 键 词：子宫脱垂 膀胱膨出 阴道后壁膨出 修复外科手术 

分 类 号：R713[医药卫生—妇产科学]