阴道前壁粘膜瓣悬吊术治疗前盆腔器官脱垂的临床疗效评价  

Clinical effect evaluation of anterior vaginal-wall mucosa flap suspension in treating patients with anterior pelvic organ prolapse

作　　者：陈永连[1] 柳晓春[1] 郑玉华[1] 王玉玲[1] 谢庆煌[1] 邓凯贤[1] 林少英[1] CHEN Yonglian;LIU Xiaochun;ZHENG Yuhua;WANG Yuling;XIE Qinghuang;DENG Kaixian;LIN Shaoying(Department of Gynecology, Foshan Maternal and Child Health Care Hospital Affiliated to Southern Medical University, Foshan 528000, Guangdong , Chin)

机构地区：[1]南方医科大学附属佛山市妇幼保健院妇科,广东佛山528000

出　　处：《中国性科学》2018年第4期63-67,共5页Chinese Journal of Human Sexuality

基　　金：广东省科技计划项目(20140212)

摘　　要：目的:探讨阴道前壁粘膜瓣悬吊术治疗前盆腔器官脱垂的临床疗效。方法:回顾性分析2013年1月至2016年1月期间佛山市妇幼保健院应用阴道前壁粘膜瓣悬吊术治疗45例前盆腔器官脱垂患者(悬吊组)的临床资料,并选择同期行传统阴道前壁修补的45例患者(传统组)作为对照,所有脱垂患者均以前壁脱垂为主,POP-Q分度为III度-IV度。通过比较两组患者手术时间,手术出血量,术后病率,住院时间,并发症发生率,手术前后的PFIQ-7,PFDI-20及PISQ量表评分。结果:(1)两组患者的术中出血量,住院时间,术后病率比较,差异无统计学意义(P>0.05)。悬吊组手术时间稍长于传统组,但差异无统计学意义(P>0.05);(2)悬吊组术后6个月的客观治愈为100.00%,术后1年,2年的客观治愈率均为93.33%(42/45);传统组术后6个月的客观治愈率为88.89%(40/45),术后1年为77.78%(35/45),术后2年为75.56%(34/45);悬吊组术后不同时期的客观治愈率均高于传统组,差异有统计学意义(P<0.05)。(3)两组患者术后症状,性生活质量均较术前改善,差异有统计学意义(P<0 05);两组之间术前PFIQ-7,PFDI-20和PISQ量表评分比较,差异无统计学意义(P>0.05);悬吊组术后同时期的PFIQ-7,PFDI-20评分低于传统组,差异有统计学意义(P<0.05);两组患者术后同时期的PISQ量表评分比较,差异均无统计学意义(P>0.05)。结论:阴道前壁粘膜瓣悬吊术治疗前盆腔器官脱垂主,客观治愈率比传统修补术高,复发率低,短期疗效确切,简单,经济,安全,对患者性生活质量的不良影响小,但需要严格把握手术适应症和掌握手术技巧。Objective： To investigate the clinical effect of anterior vaginal-wall mucosa flap suspension intreating patients with anterior pelvic organ prolapse. Methods： The clinical data of 45 patients（ suspension group）with anterior pelvic organ prolapse who were treated with anterior vaginal-wall mucosa flap suspension in Maternal and Child Health Care Hospital of Foshan City from January 2013 to January 2016 were retrospectively analyzed. 45 cases treated with conventional anterior vaginal-wall repair at the same time were selected as the control group. All the patients were with main prolapse of anterior vaginal-wall and Ⅲ to Ⅳ degree of POP-Q. The operation time,intraoperative blood loss,postoperative morbidity,hospitalization time and complications rates of two groups were compared. Results：（1）The intraoperative blood loss,hospitalization time and postoperative morbidity of two groups had no significant difference（ P〈0. 05）.（2）In suspension group,the objective cure rate at the 6^th month after operation was 100. 00%,the objective cure rates at the 1^st and 2 ^nd year after operation were both 93. 33%（ 42/45）; in control group,the objective cure rates at the 6^th month,1 ^st and 2^nd year after operation were 88. 89%（ 40/45）,77. 78%（ 35/45） and 75. 56%（ 34/45）; the objective cure rates of suspension group at different time after operation were all higher than those of control group,with significant differences（ P〈0. 05）.（3） The PFIQ-7,PFDI-20 and PISQ scores of the two groups before operation were compared,and no significant differenceswere found（ P〉0. 05）; the postoperative symptoms and sexual life quality of the two groups after operation were all better than those before operation,with significant differences（ P〈0. 05）; the PFIQ-7 and PFDI-20 scores of suspension group at the same time after operation were all lower than those of control group,with significant differences（ P〈0. 05）; the PISQ score ofthe two groups at the same time after operat

关 键 词：盆腔器官脱垂 阴道前壁脱垂 阴道前壁粘膜瓣悬吊术 盆底重建 

分 类 号：R713[医药卫生—妇产科学]