个体化治疗女性盆底脏器功能性障碍性疾病的临床效果评估  

The Clinical Evaluation of IIndividualized Treatment for Female Pelvic Organ Dysfunction Disease

作　　者：赵芳[1] 谢虹[1] 陈友国[1] Zhao Fang;Xie Hong;Chen Youguo(Department of Gynecology,First People’s Hospital of Zhangjiagang,Soochow University,Zhangjiagang,Jiangsu,215600,China)

机构地区：[1]苏州大学附属张家港市第一人民医院妇科,江苏张家港215600

出　　处：《当代医学》2019年第4期89-93,共5页Contemporary Medicine

基　　金：张家港市科技局(ZKS1723)

摘　　要：目的评价传统手术与腹腔镜下骶骨前固定术的疗效及安全性,为个体化治疗女性盆底脏器功能性障碍性疾病提供有效的临床依据。方法选取2014年1月至2016年6月张家港市第一人民医院收治的盆底功能障碍性疾病患者60例,均为Ⅲ～Ⅳ度子宫和(或)阴道前后壁脱垂患者。按照单盲法随机分为A组(传统手术组)和B组(腹腔镜下骶骨前固定术组),每组30例。比较两组患者的人口学资料是否具有统计学意义。分析两组患者术中及围手术期相关指标及围手术期并发症的发生情况。通过妇科检查,客观评价两组患者的手术治愈率。术后通过电话、门诊随访等方式,评价两组患者的术后生活质量以及对手术的满意度,了解患者术后有无出现相关并发症。结果 (1)围手术期参数对比分析结果:两组平均手术时间无统计学意义、术中出血量、残余尿量、留置尿管时间、术后住院天数B组优于A组。(2)解剖学疗效比较:根据POP-Q评分法测定,两组患者术后各点位置较术前均显著改善,差异有统计学意义(P<0.05)。但与B组患者相比,A组患者TVL长度显著缩短(P<0.05)。(3)术后客观治愈率与主观满意度比较:B组患者的客观治愈率高于A组患者,差异有统计学意义(P<0.05)。两组患者的主观满意度差异无统计学意义。(4)生活质量比较:两组患者术前PFDI-20、PFIQ-7问卷评分差异无统计学意义,术后两组患者的PFIQ-7和PFDI-20评分均明显下降,差异有统计学意义(P<0.05)。术后6个月随访时,两组患者的PFIQ-7和PFDI-20评分差异无统计学意义;术后12个月随访时B组患者的PFIQ-7和PFDI-20评分显著优于A组(P<0.05)。(5)围手术期及长期并发症比较:B组围手术期及远期并发症发生率明显低于A组(P<0.05)。结论传统手术与腹腔镜下骶骨前固定术均能有效治疗女性盆底脏器功能性障碍性疾病。两组患者主观均对手术结果满意,应根据患者的Objective To evaluate the efficacy and safety of traditional surgery and laparoscopic sacrectomy in order to provide an effective clinical basis for individualized treatment for female pelvic organ dysfunction disease.Methods The 60 patients who wereⅢtoⅣdegree uterus or vaginal anterior and posterior wall prolapse were randomly divided into group A(conventional surgery group)and group B(laparoscopic sacrectomy group),30 in each group.Demographic data were compared between the two groups for statistical significance.The indexes in intraoperative and perioperative period and the incidence of perioperative complications were analyzed in two groups.Objectively evaluate the surgical cure rate of two groups of patients through gynecological examination.The quality of life and the satisfaction of the opponents in the two groups were evaluated by telephone and outpatient follow-up,and the related complications were found out.Results The comparison of perioperative parameters:There was no significant difference in the average operation time between the two groups.Intraoperative blood loss,residual urine volume,indwelling catheter time and postoperative hospital stay in group B were superior to group A.Anatomical efficacy comparison:According to POP-Q score method,the position of postoperative points in both groups was significantly improved after operation,the difference was statistically significant(P<0.05).The TVL length in group A was significantly shorter than that in group B(P<0.05).The comparison of postoperative objective cure rate and subjective satisfaction:objective recovery rate of patients in group B was higher than that of patients in group A,the difference was statistically significant(P<0.05).There was no significant difference in subjective satisfaction between the two groups.The comparison of quality of life Before operation,There was no significant difference in PFDI-20 and PFIQ-7 questionnaires between the two groups.There was no significant difference in PFIQ-7 and PFDI-20 scores between the two gr

关 键 词：传统手术 腹腔镜下骶骨前固定术 盆腔脏器脱垂 个体化治疗 

分 类 号：R713[医药卫生—妇产科学]