对Prolift全盆底重建术与腹腔镜阴道骶骨固定术治疗重度盆腔脏器脱垂的综合评价  

Comprehensive evaluation of the treatment of Prolift system and laparoscopic sacrocolpopexy in servere pelvic organ prolapse surgery

作　　者：徐雅杰[1] 李留霞[1] 

机构地区：[1]郑州大学第一附属医院妇产科,郑州450052

出　　处：《中国实用医刊》2013年第7期45-48,共4页Chinese Journal of Practical Medicine

摘　　要：目的对Prolift全盆底重建术和腹腔镜阴道骶骨固定术在治疗重度盆腔脏器脱垂患者的，临床资料进行对比分析，评价两种术式的优劣势及适应证。方法选择2011年3月至2012年5月郑州大学第一附属医院妇产科收治的重度子宫脱垂合并阴道前后壁脱垂，以及子宫切除后阴道穹窿脱垂的行手术治疗的中老年女性患者46例，采用Prolift全盆底重建术23例（P组），腹腔镜阴道骶骨固定术（LSC）23例（L组），比较两组一般资料、围术期各项指标、经济费用和疗效，并进行统计学分析。结果两组患者一般资料比较差异无统计学意义（P〉0．05）；除P组手术时间短于L组（P〈0．05）外，两组其余围术期指标比较差异无统计学意义（P〉0．05）；两种术式的客观治愈率和主观治愈率均为100％，P、L两组分别有3、1例（13．04％、4．34％）患者出现术后性生活不适，差异有统计学意义（P〈0．05）；两种术式的费用主要区别在于补片，Prolift补片价格高于腹腔镜阴道骶骨固定术中使用的嘉美诗补片。结论Prolift全盆底重建术与腹腔镜阴道骶骨固定术均是治疗重度盆腔脏器脱垂的有效方法，前者操作相对简单，适用于无性生活要求的老年女性，但费用高；后者适用于有性生活要求的相对年轻女性，且费用较低，但操作相对复杂。Objective To analyze the clinical data of Prolifl system and laparoscopic sacrocolpopexy in treatment of servere pelvic organ prolapse（POP）, to evaluate the advantages, disadvantages and indications of the two procedure. Methods There were 46 cases of servere POP who needed surgery in the first affiliated hospital of Zhengzhou university from March 2011 to May 2012, 23 cases of them underwent the Prolift system（group P） , the others （23 cases） underwent laparoscopic sacrocolpopexy（ group L） , the data in general information, perioperation econ, omicscost and efficacy in the two groups were compared and analyzed respectively. Resuits There were no significant differences in the general information （ P 〉 0. 05 ）. The operation time of group P was shorter than that of group L （ P 〈 0.05 ） , there were no significant differences in the other peri-operation econ （P 〉 0.05）. Both of the objective cure rate and the subjective cure rate were 100% , there was 3 cases and 1 case（ 13.04% , 4. 34% ） occurred sex indisposition in group P and group L re- spectively, the difference was significant （P 〈 0. 05 ）. The main difference of the economic cost was the mesh, gynecare Prolifl＇ s price was higher than that of the gynecare mesh of laparoscopic sacrocolpopexy. Conclusions Prolift system and laparoscopic sacrocolpopexy are all the effective treatments for severe POP. The former operation is relatively simple, it is fit for the women who do not need sexual life, but the cost is expensive. The cost of the latter operation is cheap and it is appropriate for more younger who need the sexual life, however the operation is complicate.

关 键 词：盆腔器官脱垂 PROLIFT 腹腔镜阴道骶骨固定术 

分 类 号：R713[医药卫生—妇产科学]