盆底悬吊术与传统经阴道子宫切除术治疗盆底功能障碍性疾病的疗效对比  

Comparison of pelvic floor suspension and traditional transvaginal hysterectomy in the treatment of pelvic floor dysfunction

作　　者：徐静[1] 陈艳琴[1] 王家俊[1] 郑琳[1] 张红[1] 

机构地区：[1]无锡市妇幼保健院妇科,214000

出　　处：《疑难病杂志》2017年第7期709-712,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：江苏省卫计委妇幼保健重点项目(F201522)

摘　　要：目的观察比较盆底悬吊术与传统经阴道子宫切除术治疗盆底功能障碍性疾病患者的疗效。方法选取2014年1月—2015年12月无锡市妇幼保健院妇科收治的盆底功能障碍性疾病患者104例,按入院编号随机分为2组,各52例。对照组实施传统经阴道子宫切除术治疗;观察组实施盆底悬吊术治疗。观察并比较2组围手术情况、术后复发率、盆底障碍功能量表(PFRI)评分、术后并发症发生率等。结果观察组手术时间、术中出血量、术后排气时间及留置导尿管时间、住院时间等指标均优于对照组,差异有统计学意义(t=9.225、7.451、7.215、17.666、14.642,P<0.01);观察组术后12个月盆腔脏器脱垂复发率低于对照组,观察组术后6个月、12个月压力性尿失禁复发率亦低于对照组,差异有统计学意义(x2=4.616、8.217、16.798,P<0.05);与治疗前比较,观察组术后6、12个月PFRI评分均显著改善,且观察组改善程度优于对照组,观察组术后并发症发生率低于对照组,差异有统计学意义(P<0.01或P<0.05)。结论盆底悬吊术治疗盆底功能障碍性疾病疗效显著优于传统经阴道子宫切除术,可有效减少术中出血量,缩短术后排气时间和留置导尿管时间,降低病情复发率和并发症发生率,改善生活质量,促进患者早日恢复,值得推广。Objective To investigate the efficacy of pelvic floor suspension and traditional transvaginal hysterectomy in the treatment of pelvic floor dysfunction.Methods From January 2014 to December 2015,104 patients with pelvic floor dysfunction of Wuxi Maternal and Child Health Hospital gynecologywere were divided into two groups according to the admission number.Single number into the control group,the implementation of traditional vaginal hysterectomy treatment;double into the observation group,the implementation of pelvic floor suspension surgery.The perioperation,recurrence rate,pelvic floor dysfunction scale（PFRI） score and postoperative complications of the two groups were observed and compared.Results The operation time,intraoperative blood loss,postoperative exhaust time,indwelling catheter time,hospitalization time after operation were better than those in the control group,the difference was statistically significant（t=9.225,7.451,7.215,17.666,14.642,P0.01）;the observation group after 12 months of pelvic organ prolapse recurrence rate was lower than the control group,the observation group after 6 months and 12 months of stress urinary incontinence recurrence rate compared to the control group were lower,the difference was statistically significant（χ~2=4.616,8.217,16.798,P0.05）;compared with that before operation,the PFRI score of the patients in the observation group was improved 6 and 12 months after operation,and the observation group was better than in the control group,the observation group the incidence of postoperative complications was lower than the control group,the difference was statistically significant（P0.01,P0.05）.Conclusion Pelvic floor suspension treatment of pelvic floor dysfunction is significantly better than the traditional transvaginal hysterectomy.

关 键 词：盆底悬吊术 经阴道子宫切除术 盆底功能障碍性疾病 盆底障碍功能量表评分 复发率 

分 类 号：R713[医药卫生—妇产科学]