2种手术方式治疗盆腔脏器脱垂效果比较  

Comparison of two surgical methods for pelvic organ prolapse

作　　者：王君[1] 杨冬[1] 张军[1] 孔佳[1] 李斌[1] 张震宇[2] 

机构地区：[1]首都医科大学附属北京安贞医院妇产科,北京100029 [2]北京朝阳医院妇产科,北京100020

出　　处：《中华实用诊断与治疗杂志》2016年第5期458-460,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：首都医学发展科研基金资助项目(2011-2003-03)

摘　　要：目的探讨Prolift全盆悬吊术和经阴道子宫切除+阴道前后壁修补术2种手术方式治疗盆腔脏器脱垂的临床效果差异。方法 90例盆腔脏器脱垂患者,采用Prolift全盆悬吊术治疗30例为观察组,60例采用经阴道子宫切除+阴道前后壁修补术治疗者为对照组。比较2组手术时间、术中出血量、术后保留导尿时间、住院时间、术后阴道长度及疗效。结果观察组手术时间[(69.5±11.3)min]较对照组[(124.7±14.0)min]短,术中出血量[(58.7±18.0)mL]较对照组[(133.5±26.4)mL)]少,差异有统计学意义(P<0.05);观察组术后保留导尿时间[(5.3±1.2)d]、住院时间[(8.2±1.7)d]与对照组[(5.7±1.5)、(8.5±2.0)d]比较差异无统计学意义(P>0.05);术后观察组阴道长度[(6.39±0.45)cm]与术前[(6.42±0.47)cm]比较差异无统计学意义(P>0.05),大于对照组术后[(5.86±0.55)cm](P<0.05);随访12个月,观察组治愈率(93.33%)高于对照组(73.33%),差异有统计学意义(P<0.05);观察组术后并发症发生率(10.0%)与对照组(15.0%)比较差异无统计学意义(P>0.05)。结论盆腔脏器脱垂采用Prolift全盆悬吊术重建盆底功能,其疗效优于经阴道子宫切除+阴道前后壁修补术。Objective To compared the surgical outcomes of Prolift whole pelvic suspension surgery and transvaginal hysterectomy ＋ repair of anterior and posterior vaginal wall for pelvic organ prolapsed. Methods In 90 patients with pelvic organ prolapsed, 30 patients received Prolift whole pelvic suspension surgery （observation group）, and 60 patients received transvaginal hysterectomy ＋ repair of anterior and posterior vaginal wall （control group）. The operation lasting time, intraoperative blood loss, retention time of catheterization, hospitalization duration, postoperative vaginal length and follow-up results were compared between two groups. Results The operation lasting time was significantly shorter （（69.5 ± 11.3） min） and intraoperative blood loss was significantly less （（58.7 ± 18.0） mL） in observation group than those in control group （（124.7±14.0） rain, （133.5±26.4） mL） （P〈0.05）. There were no significant differences in the retention time of catheterization and hospitalization stay between observation group （（5.3±1.2）, （8.2±1.7） d） and control group （（5. 7 ± 1. 5）, （8. 5± 2. 0） d）（P〉0.05）. The postoperative vaginal length was significantly longer in observation group （（6. 39±0. 45） cm） than that in control group （（5. 86±0. 55） cm） （P〈0.05）, and showed no significant difference in comparison with that before operation （（6. 42±0.47） cm）. The curative rate after 12-month follow-up was significantly higher in observation group （93.33%） than that in control group （73. 330/00） （P〈0.05）. There was no significant difference in the incidence of complications between observation group （10. 0%） and control group （15.0%） （P〉0.05）. Conclusion Pelvic reconstruction surgery by prolift whole basin sling is effective for pelvic organ prolapse, and is better than TVH ＋ repair of anterior and posterior vaginal wall repair.

关 键 词：盆腔脏器脱垂 Prolift全盆悬吊术 经阴道子宫切除 阴道前后壁修补术 

分 类 号：R713[医药卫生—妇产科学]