同时行抗压力性尿失禁手术在盆腔器官脱垂患者盆底重建手术中的有效性的Meta分析  

The Necessary of Concomitant Anti-incontinence Procedure in Pelvic Organ Prolapse Repair: A Meta Analysis

作　　者：闵洁[1] 洪莉[1] 李秉枢[1] 洪莎莎[1] 方桂[1] 张小红[1] 胡鸣[1] 赵杨[1] 杨青[1] 

机构地区：[1]武汉大学人民医院,湖北武汉430060

出　　处：《实用妇产科杂志》2015年第2期130-135,共6页Journal of Practical Obstetrics and Gynecology

基　　金：湖北省科技支撑计划项目(编号:2014BCB045);湖北省卫生厅项目(编号:NX2011-5);武汉大学协同创新项目(编号:523-266078)

摘　　要：目的：分析比较盆腔器官脱垂（POP）患者同时行盆底重建手术及抗压力性尿失禁手术和单纯行盆底重建手术的术后疗效。方法：计算机检索1999-2013年间Cochrane library、Embase、Medline等数据库。纳入符合条件的英文随机对照试验（RCT）文献,进行质量评估。运用RevMan5.0软件进行Meta分析。结果：7个RCT文献纳入研究（n=642）,经过Meta分析,单纯行盆底重建手术与盆底重建手术同时行抗压力性尿失禁手术相比,术后压力性尿失禁（RR=1.45,95%CI0.72-2.93,P=0.30）、急迫性尿失禁（RR=1.44,95%CI 0.73-2.84,P=0.29）、术后膀胱膨出（RR=1.30,95%CI 0.35-4.84,P=0.69）、术后性交困难（RR=1.20,95%CI 0.35-4.06,P=0.77）、术后再发POP（RR=0.87,95%CI 0.19-3.99,P=0.86）发生率和生活质量调查评分差异均无统计学意义。结论：和单纯盆底重建手术相比,同时行抗压力性尿失禁手术不能提高患者术后疗效,应妥善选择手术方式。Objective： To compare the operation efficiency between combined usage concomitant anti-incontinence procedure and pelvic organ prolapse repair,and only pelvic organ prolapse repair. Methods： Searches were made in the databases of Cochrane library,Embase,Medline for randomized controlled trials from 1999 to 2013 on the surgery treatment of POP women. The quality analysis of the literatures were evaluated. The meta analysis was analyzed by Rev Man V5. 0 software. Results： Seven RCT（ n = 642） were included. There were no significant difference between the group undergoing the pelvic organ prolapse repair with concomitant anti-incontinence procedure and the group undergoing pelvic organ prolapse repair alone without an anti-incontinence procedure in postoperative stress incontinence（ RR = 1. 45,95% CI 0. 72- 2. 93,P = 0. 30）,postoperative urge incontinence（ RR=1. 44,95%CI 0. 73-2. 84,P =0. 29）,postoperative cystocele（ RR = 1. 30,95% CI 0. 35-4. 84,P = 0. 69）,postoperative dyspareunia（ RR = 1. 20,95% CI 0. 35-4. 06,P = 0. 77）,reoccurrence of prolapsed（ RR = 0. 87,95%CI 0. 19-3. 99,P = 0. 86）,postoperative complication questionnaires and VAS score（ P〉0. 05）. Conclusions： The concomitant anti-incontinence procedure is not necessary in POP patients undergoing surgery for pelvic organ prolapse repair,since the former procedure cannot improve the post-operation efficacy.

关 键 词：盆腔器官脱垂 盆底重建 尿失禁 META分析 

分 类 号：R711.2[医药卫生—妇产科学]