雌三醇在绝经后女性盆底功能障碍性疾病围手术期的应用时机研究  

Timing of clinical application of estriol in perioperative period of postmenopausal women with pelvic floor dysfunction

作　　者：魏来 朱国智 夏志军[2] 

机构地区：[1]辽宁省昌图县中心医院妇产科,辽宁铁岭112599 [2]中国医科大学附属盛京医院,沈阳110004

出　　处：《实用药物与临床》2017年第9期1015-1018,共4页Practical Pharmacy and Clinical Remedies

基　　金：国家科技部十二五"重大新药创制"科技重大专项课题(2012ZX09401004);中华预防医学会科研资金支持项目(20130606)

摘　　要：目的探讨雌三醇用药时间对绝经后女性盆底功能障碍性疾病患者围手术期的临床疗效。方法选择我院妇科病房2013年9月至2016年9月收治的116例绝经后女性(POP-QⅢ~Ⅳ度盆腔脏器脱垂)患者,伴或不伴有压力性尿失禁,患者均行全盆底重建术,伴压力性尿失禁患者同时行TVT-O术。将患者分成2组,观察组(60例)术前及术后均阴道局部应用雌三醇软膏,对照组(56例)术前未用雌三醇软膏,仅术后阴道局部应用雌三醇软膏。分析比较两组术中情况及术后恢复、不良反应等围手术期指标,包括平均手术时间、术中阴道分离难易评分、术中出血量,以及留置尿管、切口愈合、阴道排液、线结脱落的平均时间等。结果观察组平均手术时间、术中阴道分离难易评分、术中出血量分别为(60.16±18.02)min、(4.17±0.86)分、(61.93±37.62)m L,对照组分别为(83.27±21.14)min、(2.98±1.12)分、(105.36±42.14)m L,两组比较差异均有统计学意义(P<0.05)。观察组留置尿管、切口愈合、阴道排液、线结脱落平均时间分别为(4.16±1.10)、(5.12±2.17)、(12.64±3.52)、(66.19±15.67)d,对照组分别为(6.88±2.32)、(8.01±3.73)、(23.67±3.98)、(90.21±10.26)d,两组比较差异均有统计学意义(P<0.05)。观察组术后不良反应发生率为21.67%,对照组为51.78%,两组比较差异有统计学意义(P<0.05)。结论绝经后女性盆底功能障碍患者围手术期阴道应用雌三醇术中创伤小、术后恢复快、不良反应少,术前及术后联合应用雌三醇者疗效优于单独术后应用。Objective To explore the clinical efficacy of application time of estriol in perioperative period of postmenopausal women with pelvic floor dysfunction. Methods A total of 116 postmenopausal women with POP（ stageⅢ to Ⅳ according to POP-Q staging）,with or without stress urinary incontinence,treated in Gynecology department of our hospital from September 2013 to September 2016 were selected. All patients received total pelvic floor reconstruction,and the patients with stress urinary incontinence received TVT-O at the same time. The patients were divided into 2 groups,patients in observation group（ n = 60） used estriol ointments locally before and after operation,and patients in control group（ n = 56） used estriol ointments only after operation. The perioperative conditions,postoperative recovery and adverse reactions of the two groups were analyzed and compared. Results The average operation time,difficulty of vaginal separation and intraoperative blood loss in observation group were（ 60. 16 ± 18. 02） min,（ 4. 17 ± 0. 86） degree,and（ 61. 93 ± 37. 62） m L,and those in control group were（ 83. 27 ± 21. 14） min,（ 2. 98 ± 1. 12）degree,and（ 105. 36 ± 42. 16） m L,the differences being statistically significant between the two groups（ P〈0. 05）. The average time of indwelling catheter,incision healing,vaginal drainage and line fall were（ 4. 16 ± 1. 10） d,（ 5. 12 ±2. 17） d,（ 12. 64 ± 3. 52） d and（ 66. 19 ± 15. 67） d in observation group and（ 6. 88 ± 2. 32） d,（ 8. 01 ± 3. 73） d,（ 23. 67 ± 3. 98） d and（ 90. 21 ± 10. 26） d in control group,there were significant differences between the two groups（ P〈0. 05）. The harmful effect related to operation was 21. 67% in observation group and 51. 78% in control group,and the differences were statistically significant between the two groups（ P〈0. 05）. Conclusion For women with pelvic floor dysfunction after menopause,the use of estriol in perioperative period has the advantage of less t

关 键 词：雌三醇 女性盆底功能障碍性疾病 围手术期 应用时机 

分 类 号：R713[医药卫生—妇产科学]