阴道部分封闭术治疗重度盆底器官脱垂的疗效分析  

Effect of partial vaginal closure in treatment of severe pelvic organ prolapse

作　　者：杨柳风[1] 王旭燕 肖静 邵芳 YANG Liufeng;WANG Xuyan;XIAO Jing;SHAO Fang(Department of Obstetrics and Gynecology,the Fifty-Ninth Central Hospital of PLA,Kaiyuan 661600,Yunnan Province,China)

机构地区：[1]解放军第59医院妇产科,云南开远661600

出　　处：《解放军医学院学报》2018年第9期775-777,781,共4页Academic Journal of Chinese PLA Medical School

摘　　要：目的观察阴道部分封闭术治疗重度盆底器官脱垂的疗效。方法选取2016年1月-2017年1月于本院接受治疗的重度盆底器官脱垂患者56例,根据手术方式将患者分为阴道封闭组(n=20)及传统手术组(n=36),观察阴道部分封闭术治疗重度盆底器官脱垂的疗效。结果阴道封闭组术中出血量[(204.65±20.36) ml vs (294.65±30.29)] ml、手术时间[(1.21±0.25) h vs (1.76±0.14) h]、术后下床时间[(1.52±0.58) d vs (2.01±0.64) d]、住院时间[(7.25±1.36) d vs (9.25±1.24) d]均显著低于传统手术组(P均<0.05)。两组手术前PFDI-20及PFIQ-7评分均无统计学差异(P> 0.05);术后随访1年,两组评分均较前明显改善,且阴道封闭组优于传统手术组(4.25±1.02 vs 7.25±1.59,P=0.000;44.92±19.36 vs57.25±18.25,P=0.038)。阴道封闭组治疗总有效率高达95.00%,传统手术组总有效率仅为69.44%,差异有统计学意义(P=0.000)。结论相比传统手术,阴道部分封闭术治疗重度盆底器官脱垂效果显著,值得临床推广使用。Objective To observe the effect of partial vaginal closure in the treatment of severe pelvic organ prolapse.Methods Fifty-six patients with severe pelvic organ prolapse admitted to our hospital from January 2016 to January 2017 were enrolled in our study.According to the patients＇ choice of surgical methods,they were divided into vaginal closure group（n=20）and traditional surgery group（n=36）.The effect of transvaginal reconstruction of pelvic floor and partial closure of vagina were observed and compared.Results The intraoperative blood loss [（204.65±20.36） ml vs（294.65±30.29） ml], operating time [（1.21±0.25） h vs（1.76±0.14） h],time of getting out of bed after operation [（1.52±0.58） d vs（2.01±0.64） d] and hospital stay [（7.25±1.36） d vs（9.25±1.24） d] in the vaginal closure group were significantly lower or shorter than those in traditional operation group（all P〈0.05）. There was no significant difference in PFDI-20 and PFIQ-7 scores between the two groups before operation（P〈0.05）. After 1 year of followup, the scores of the two groups improved significantly, and the improvement was greater in vaginal closure group compared with traditional surgery group（4.25±1.02 vs 7.25±1.59, P=0.000; 44.92±19.36 vs 57.25±18.25, P=0.038）. The total effective rate of vaginal closure group was 95.00%, which was significantly higher than the traditional operation group（69.44%）（P=0.000）.Conclusion Compared with traditional surgery, partial closure of vagina is more helpful for pelvic floor function recovery, improving therapeutic effect and long-term prognosis of patients, which is worthy of clinical application.

关 键 词：阴道部分封闭术 重度盆底器官脱垂 子宫切除术 

分 类 号：R713.3[医药卫生—妇产科学]