经阴道植入网片盆底重建术后网片暴露发生情况及危险因素分析  

Study on risk factors with the occurrence of the mesh exposure after pelvic floor reconstruction

作　　者：黄惠娟[1] 宋岩峰[1] 郑小花[1] 王凤玫[1] 郑鲤榕[1] 

机构地区：[1]南京军区福州总医院妇产科,350025

出　　处：《中华妇产科杂志》2014年第1期26-29,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的分析经阴道植入网片盆底重建术后网片暴露发生情况及相关危险因素。方法回顾性分析2007年3月至2011年3月353例行经阴道植人网片盆底重建术患者的临床资料，调查其网片相关并发症发生情况，并应用单因素和多因素logistic回归分析术后网片暴露的危险因素。结果术后1年随访发现网片暴露发生率为9．6％（34／353）。单因素分析表明，年龄≥70岁、绝经、产次≥3次、盆底手术史、糖尿病病史、吸烟史与盆底重建术后网片暴露发生显著相关（P均〈0．05）。多因素logistic回归分析表明，盆底手术史（OR=5．385）、糖尿病病史（OR=3．545）、产次≥3次（OR=2．688）及年龄≥70岁（OR=2．389）是盆底重建术后网片暴露发生的独立危险因素，手术者经验是其保护因素（OR=0．134）。结论网片暴露是盆底重建术后的常见并发症，高龄、多次分娩、糖尿病病史和盆底手术史可能是其发生的危险因素，术前充分评估，加强培训，严格掌握适应证，有望降低其发生率。Objective To study risk factors with the occurrence of the mesh exposure after pelvic floor reconstruction. Methods From Mar. 2007 to Mar. 2011 ,a retrospective study was made on the clinical data of 353 patients undergoing vaginal mesh pelvic floor reconstruction. The related complications of the mesh were surveyed, and risk factors associated with the mesh＇s exposure were studied by single factor and multiple factors logistic regression. Results It was found that the exposure rate was 9.6% （34/353） after 1 year postoperative follow-up. Single factor analysis showed that patients who were not less than 70 years old, patients who were on their menopause stage, the occurrence of not less than three parturition, history of pelvic surgery, diabetes and smoking had a significant correlation （ all P 〈 0. 05 ） with the occurrence of the mesh exposure after pelvic floor reconstruction. Multiple factors logistic regression analysis showed that patients who were not less than 70 years of age （ OR = 2. 389 ）, the occurrence of not less than three parturition （ OR = 2. 688 ）, the history of diabetes （ OR = 3. 545 ）, the history of pelvic surgery （ OR = 5. 385） were the independent risk factors, and the operation experience was the protection factors （ OR = 0. 134）. Conclusions Mesh exposure is a common complication after pelvic floor reconstruction. Old age, multiple delivery, history of diabetes and history of pelvic surgery are the risk factors of mesh exposure. Preoperative full assessment and the quality of training contribute to reduce the incidence.

关 键 词：骨盆底 妇科外科手术 外科网 危险因素 

分 类 号：R713[医药卫生—妇产科学]