改良盆底重建术和经阴道子宫切除术治疗盆腔脏器脱垂性疾病的临床意义  

Clinical significance of modified pelvic reconstructive surgery and vaginal hysterectomy in the treatment of pelvic organ prolapse

作　　者：何科[1] 瞿虎[2] 费慧[1] 牛刚[1] 

机构地区：[1]中山大学附属第一医院妇产科,广东广州510080 [2]中山大学附属第六医院泌尿外科/生殖医学中心,广东广州510655

出　　处：《中国现代医生》2016年第6期52-55,共4页China Modern Doctor

基　　金：广东省科技计划项目(2011B061300048)

摘　　要：目的探讨改良盆底重建术和经阴道子宫切除术（TVH）治疗盆腔脏器脱垂性疾病的临床效果。方法随机选取2012年1月~2013年12月期间我院收治的盆腔脏器脱垂性疾病患者76例作为研究对象,按手术方式的不同,将接受TVH加阴道前后壁修补术治疗的38例患者作为对照组,将接受TVH加改良盆底重建术治疗的38例患者作为观察组,观察和比较两组的手术效果。结果两组患者手术时间、术中出血量、术后保留尿管时间及住院时间比较差异无统计学意义（P〉0.05）;两组患者治疗前后PFID-20评分、PISQ-12评分比较,差异有统计学意义（P〈0.05）;观察组治疗后PFID-20评分、PISQ-12评分分别为（13.28±3.17）分、（20.17±2.18）分,对照组（14.28±3.42）分、（20.45±2.37）分,差异无统计学意义（P〉0.05）;观察组复发率为2.63%,对照组复发率为15.79%,差异有统计学意义（P〈0.05）;观察组性生活质量下降率为5.26%,对照组性生活质量下降率为21.05%,差异有统计学意义（P〈0.05）。结论改良盆底重建术作为一种新术式,可更好地实现结构重建及组织替代,可有效修补缺陷,且复发率低,可作为盆腔脏器脱垂性疾病的理想术式。Objective To probe into the clinical effects of modified pelvic reconstructive surgery and vaginal hysterectomy in the treatment of pelvic organ prolapse. Methods A total of 76 patients who suffered from the pelvic organ prolapse and accepted treatments in our hospital from January 2012 to December 2013 were taken as the research objects,and according to the different surgical methods, 38 patients who treated with TVH plus anterior and posterior vaginal wall repair as the control group, 38 patients who treated with TVH and modified pelvic reconstructive surgery as the observation group. Then,the operation effect of two groups of patients were observed and compared. Results There was no significant difference in operation time, bleeding volume, postoperative retention time and hospitalization time between the two groups（P〈0.05）; The PFID-20 scores, PISQ-12 scores had significant differences between two groups before treatment and after treatment. After treatment, the PFID-10 score, PISQ-12 score in the observation group were（13.28±3.17） scores,（20.17±2.18） scores,the control group was（14.28±3.42） scores,（20.45±2.37） scores, and the difference had statistically significant（P〉0.05）; In addition, the recurrence rate in the observation group was 2.63%, the control group was 15.79%, and the difference was statistically significant（P〈0.05）; The quality of life rate in the observation group was 5.26%, the control group was 21.05%, and the difference was statistically significant（P〈0.05）. Conclusion The modified pelvic reconstructive surgery as a new type of operation,which can be better realize the structural reconstruction and tissue replacement, can effectively repair the defect and the recurrence rate, thus can be used as an ideal type of pelvic organ prolapse disease.

关 键 词：盆腔脏器脱垂性疾病 改良盆底重建术 经阴道子宫切除术 阴道前后壁修补术 

分 类 号：R656[医药卫生—外科学]