子宫脱垂手术是否联合生物补片治疗的临床疗效差异分析  

Clinical Effects of Surgical Repair with or Without Biological Mesh on Uterine Prolapse

作　　者：鲍春玉 李小钊[1] 应小燕[1] 

机构地区：[1]南京医科大学第二附属医院妇产科,南京210011

出　　处：《中国微创外科杂志》2017年第5期415-417,457,共4页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨生物补片联合阴式全子宫切除术+阴道前后壁修补术治疗子宫脱垂的临床效果。方法回顾性分析2010年1月~2015年5月我院106例子宫脱垂行阴式全子宫切除术+阴道前后壁修补术,其中联合生物补片治疗75例(实验组),单纯手术31例(对照组),比较2组手术时间、术中出血量、术后排气时间、术后住院时间和术后疗效。结果 2组手术均顺利完成,对照组和实验组手术时间分别(91.4±3.4)、(95.1±10.2)min,无统计学差异(t=-1.970,P=0.051);出血量分别(34.5±7.3)、(32.1±4.9)ml,无统计学差异(t=1.973,P=0.051);术后排气时间分别(29.2±4.8)、(30.2±5.3)d,无统计学差异(t=-0.907,P=0.366);术后住院时间分别(6.1±1.5)、(6.0±1.4)d,无统计学差异(t=0.328,P=0.744)。术后1年实验组治愈74例,好转1例,无复发,对照组治愈27例,好转1例,复发3例,实验组症状改善有效率明显高于对照组(Z=-2.571,P=0.010)。结论子宫脱垂患者如无需保留子宫,在无禁忌的情况下首选生物补片联合阴式子宫切除+阴道前后壁修补术,疗效好,复发率低。Objective To analyze the different clinical effects of colpohysterectomy combined with anterior and posterior wall colporrhaphy with or without biological mesh for uterine prolapse. Methods From January 2010 to May 2015, colpohysterectomy combined with anterior and posterior wall colporrhaphy was performed in 106 cases of uterine prolapse, including 75 cases receiving biological mesh repair （experimental group） and 31 cases of non-biological mesh （control group）. Clinical and surgical information of all patients was collected, and satistial analysis was done between the two groups. Results All the operations were accomplished successfully. There were no statistical differences in bleeding amount during operation [ （34.5 ± 7.3 ） ml vs. （32.1 ± 4.9） ml, t = 1. 973, P = 0. 051 ], time to first flatus [ （29.2 ± 4.8） d vs. （30.2 ± 5.3） d, t = - 0. 907, P = 0. 366 ], postoperative hospital stay [（6.1 ±1.5） d vs. （6.0±1.4） d, t=0.328, P=0.744], as well as the operative time [（91.4 ±3.4） min vs. （95.1 ±10.2） min, t = - 1. 970, P = 0.051 ]. At one year after surgery, in the experimental group there were 74 patients cured, 1 patient improved, and no invalid or recurrence case, while in the control group there were 27 patients cured, 1 patient improved, 3 cases of recurrence and no invalid case. The treatment effect of the experimental group was significant better than that of the control group （Z = - 2. 571, P = 0. 010）. Conclusions Colpohystereetomy with anterior and posterior wall eolporrhaphy with biologieal mesh can be selected for uterine prolapse patients without eontraindications. The results of surgery are better with biological mesh, with low recurrence rate.

关 键 词：子宫脱垂 阴式子宫切除术 阴道前后壁修补术 生物补片 

分 类 号：R713.4[医药卫生—妇产科学]