生物补片治疗老年子宫脱垂的疗效评价  

Therapeutic effect of biological mesh in the treatment of elderly patients with uterine prolapsed

作　　者：陈林花 应小燕[1] CHEN Lin-hua;YING Xiao-yan(Nanjing Medical University,Nanjing 210011,China)

机构地区：[1]南京医科大学,江苏省南京市210011

出　　处：《实用老年医学》2020年第3期274-278,共5页Practical Geriatrics

摘　　要：目的探讨生物补片治疗老年子宫脱垂的临床效果。方法根据盒底器官脱垂评估系统(POP-Q)选择60例子宫脱垂程度为Ⅱ度及以上的老年子宫脱垂病人,依据随机数字表平均分为对照组和试验组,对照组行阴式子宫切除术(TVH)+阴道前后壁修补术,试验组在对照组基础上应用生物补片治疗。观察2组的手术情况,并记录治疗前及治疗后12个月2组Aa、Ba、C、Ap、Bp等位置的POP-Q评分,比较2组病人的生活质量变化和3D-MRI检查结果。结果2组手术时间、术中出血量、导尿管留置时间、术后残余尿量和术后住院时间差异均无统计学意义(P>0.05)。治疗后,试验组Aa、Ba、C、Ap、Bp位置的POP-Q评分均优于对照组(P<0.05);试验组盆底功能障碍性疾病症状问卷简表20(PFDI-20)、POP困扰量表(POPDI-6)、结直肠肛门困扰量表(CRADI-8)和排尿困扰量表(UDI-6)评分均低于对照组(P<0.05);试验组静息位、Valsalva动作位的M线小于对照组,C线大于对照组(P<0.05),PCL、H线、G1角、G2角与对照组差异无统计学意义(P>0.05),而Valsalva动作位的B线大于对照组(P<0.05)。结论生物补片不影响TVH的手术效果,可重建老年子宫脱垂病人的盆底结构,改善子宫脱垂程度及术后生活质量。Objective To investigate the clinical effect of biological mesh in the treatment of elderly patients with uterine prolapse.Methods Sixty elderly patients with pelvic organ prolapse quantition(POP-Q)gradeⅡor above were divided into control group and experimental group according to random number table,with 30 cases in each group.The control group were treated with transvaqinal hyattreetony(TVH)plus vaginal anterior or posterior wall repair,and the experimental group was treated with biological mesh on the basis of the control group.The condition of surgical operation was observed in both groups,and the POP-Q scores of Aa,Ba,C,Ap and Bp were recorded before treatment and 12 months after treatment.The changes of quality of life and the results of 3D-MRI were compared between the two groups.Results There were no significant differences in operation time,intraoperative bleeding volume,indwelling time of catheter,residual urine volume and hospitalization time between the two groups(P>0.05).After treatment,the POP-Q scores of Aa,Ba,C,Ap and Bp in the experimental group were better than those in the control group(P<0.05);the scores of PFDI-20,POPDI-6,CRADI-8 and UDI-6 in the experimental group were lower than those in the control group(P<0.05);the M line of resting position and Valsalva action position in the experimental group were shorter than those in the control group,while the C line was longer(P<0.05),and there were no significant differences in PCL,H line,G1 angle and G2 angle(P>0.05).The B line of Valsalva action position was longer than that in the control group(P<0.05).Conclusions Biological mesh does not affect the effects of TVH,which can reconstruct the pelvic floor structure of elderly patients with uterine prolapse,improve the degree of uterine prolapse and the quality of life.

关 键 词：子宫脱垂 老年人 生物补片 阴式子宫切除术 疗效 

分 类 号：R711.23[医药卫生—妇产科学]