聚丙烯补片在改良盆底重建修复盆腔脏器脱垂中的应用  

Improved pelvic floor reconstruction with polypropylene mesh for repair of pelvic organ prolapse

作　　者：谢虹[1,2] 黄海伟[1] 马新[1] 赵芳[1] 张琳[1] 

机构地区：[1]苏州大学医学院附属张家港医院妇科,江苏省张家港市215600 [2]张家港市第一人民医院妇科,江苏省张家港市215600

出　　处：《中国组织工程研究》2015年第12期1899-1903,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:合成补片是重要的盆底组织替代物,能够替代薄弱受损的盆底筋膜组织,己被广泛应用于盆底薄弱组织的修补重建中。目的:观察补片在改良盆底重建修复盆腔脏器脱垂的疗效及并发症,探讨其安全性及有效性。方法:纳入45例女性盆腔脏器脱垂患者,根据患者意愿分两组治疗,试验组25例经阴道植入聚丙烯补片进行改良盆底重建修复,对照组20例采用传统经阴道全子宫切除联合阴道壁修补治疗,记录两组围手术期情况,随访评价两组子宫脱垂分期、并发症、盆底功能及盆底不适情况,以及客观治愈率。结果与结论:与对照组比较,试验组手术时间短、出血量小、感染轻、恢复快(P均<0.05)。随访6个月时,试验组子宫脱垂分期评分高于对照组;随访12个月时,试验组并发症发生率、盆底功能影响评分及盆底不适情况评分均低于对照组(P<0.05),客观治愈率高于对照组(P<0.05)。表明采用聚丙烯补片进行盆底重建修复盆腔脏器脱垂具有手术时间短、出血量小、恢复快、裸露率低等特点,同时能显著提高盆底功能,改善盆底不适情况,降低术后并发症的发生,提高客观治愈率,短期随访安全有效。BACKGROUND：Synthetic patch as an important substitute to pelvic tissue can replace damaged pelvic fascia tissue, and has been widely used in the pelvic floor reconstruction. OBJECTIVE：To observe the efficacy and complications of pelvic floor reconstruction with mesh, and to explore its safety and effectiveness. METHODS： Forty-five pelvic organ prolapse female patients were divided into two groups according to patient’s wilingness： experimental group, pelvic floor reconstruction with mesh （n=25）; control group, transvaginal hysterectomy combined with vaginal wal repair （n=20）. Perioperative conditions were recorded, and uterine prolapse staging, complications, pelvic floor function, pelvic discomfort, as wel as an objective cure rate were evaluated in the two groups during the folow-up. RESULTS AND CONCLUSION：Compared with the control group, the experimental group was characterized as shorter operative time, less amount of bleeding, milder infections, and faster recovery （AlP 〈 0.05）. At 6 months of folow-up, the score on uterine prolapse staging was higher in the experimental group than the control group; at 12 months, the scores on pelvic floor function and pelvic discomfort as wel as the incidence of complications＆nbsp;were significantly lower in the experimental group （P 〈 0.05）, but the objective cure rate was higher compared with the control group （P 〈 0.05）. These findings suggest that pelvic floor reconstruction with mesh for pelvic organ prolapsed can reduce the operative time and blood loss and promote postoperative recovery. Meanwhile, it can significantly improve pelvic floor function, pelvic discomfort, postoperative complications, the rate of exposure, and the objective cure rate, which is safe and effective during the short-term folow-up.

关 键 词：生物材料 材料相容性 补片 盆底重建 盆腔器官脱垂 传统经阴道子宫全切 

分 类 号：R318[医药卫生—生物医学工程]