改良经皮下无张力阴道悬吊术对女性盆底功能障碍性疾病的治疗效果  

The treatment of female pelvic floor dysfunction by the modified percutaeous tension-free vaginal tape

作　　者：张蕾[1] 邵振堂[1] 

机构地区：[1]南京市妇幼保健院妇产科,南京210004

出　　处：《现代妇产科进展》2012年第8期613-616,共4页Progress in Obstetrics and Gynecology

基　　金：南京医科大学科技发展基金重点项目(No:2010NJMUZ16)

摘　　要：目的:评估改良经皮下无张力阴道悬吊术对女性盆底功能障碍性疾病(PFD)治疗的有效性和安全性。方法:对60例盆腔器官膨出患者采用改良经皮下无张力阴道悬吊术,尝试自行修剪聚丙烯网片,以自创的简便网片经皮下固定位点进行盆底修补和重建,分析术中情况,随访治疗效果。结果:60例患者平均年龄60.73岁(37～78岁);平均手术时间88min(55～130min);术中平均出血131ml(80～300ml),无一例术中输血;平均住院时间为11天(8～18天);术后随访时间平均23.3个月(4～52个月),发现7例术后网片侵蚀,发生率为11.67%,2例复发,治愈率为96.7%,无网片感染发生;其中15例压力性尿失禁,11例症状消失,治愈率为73.3%,4例症状改善,尿频尿急13例中9例症状消失,2例改善。结论:改良经皮下无张力阴道悬吊术用于PFD患者的手术治疗,操作简便,易于掌握,并发症少,近期疗效稳定,经济实用,对于我国基层PFD患者的治疗具有积极意义。Objective：To evaluate the effectiveness and safety of the modified percutaneous tension-free vaginal tape in the treatment of female pelvic floor dysfunction（PFD）.Methods：A total of 60 women with pelvic organ prolapse treated with the modified percutaneous tension-free vaginal tape were studied.The detail of treatment was analyzed by clinical parameters and the effectiveness of treatment was evaluated by follow-up.Results：All of the patients,the average age was 60.73 years（37~78y）,the mean time of operation was 88min（55~130min）,the average loss of blood in operation was 131ml（80~300ml） and the average hospital stay time was 11days（8~18d）.During a mean of 23.3 months（4~52m） follow-up,there were 7 cases with mesh erosion（11.67%）,2 cases with recurrence,and the cure rate was 96.7%.There were no mesh infection and other operation-related complications.The symptom of stress urinary incontinence（SUI） disappeared in 11 patients and alleviated in 4 patients of 15 patients after treatment,the cure rate was 73.3%.The symptom of denovo urgency disappeared in 9 patients and alleviated in 2 patients of 13 patients.Conclusion：The modified percutaneous tension-free vaginal tape is an easy and safe treatment for female pelvic floor dysfunction（PFD）.It 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：改良经皮下无张力阴道悬吊术 盆底功能障碍性疾病 聚丙烯网片 盆底重建 

分 类 号：R711[医药卫生—妇产科学]