阴道骶骨固定术对女性尿动力及盆底肌电生理的影响  

Effect of sacrocolpopexy on female urodynamics and pelvic floor electrophysiology

作　　者：都红蕾[1] 刘剀[1] 熊军波 姚秀华[1] 王佳慧[1] 郑峥[1] DU Honglei;LIU Qi;XIONG Junbo;YAO Xiuhua;WANG Jiahui;ZHENG Zheng(Department of Gynecology,Shenzhen Maternal and Child Health Hospital Affiliated to Southern Medical University,Shenzhen 518028,China)

机构地区：[1]南方医科大学附属深圳市妇幼保健院妇科,广东深圳518028

出　　处：《中华实用诊断与治疗杂志》2020年第2期135-138,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：广东省医学科技术研究基金项目(A2017580)。

摘　　要：目的探讨阴道骶骨固定术对女性尿动力和盆底肌电生理的影响。方法 50例盆腔器官脱垂患者,根据手术方式分为观察组30例和对照组20例,观察组采用阴道骶骨固定术进行治疗,对照组采用传统手术进行治疗。2组手术前、后采用盆腔器官脱垂的定量评分评估解剖复位情况,比较手术前、后尿动力学指标腹压漏尿点压、最大尿流率时逼尿肌压、最大尿道闭合压、膀胱顺应性,比较手术前及手术后3、6、12个月盆底肌电生理变化情况。结果观察组盆腔器官脱垂的定量评分Aa、Ba、C、Ap、Bp点手术前后差值[(5.01±0.42)、(7.73±0.56)、(12.79±0.41)、(4.60±0.31)、(5.09±0.67)cm]均大于对照组[(3.42±0.39)、(6.13±0.53)、(10.27±0.35)、(3.34±0.27)、(3.62±0.55)cm](P<0.05);2组术前腹压漏尿点压、最大尿流率时逼尿肌压、最大尿道闭合压及膀胱顺应性比较差异均无统计学意义(P>0.05);观察组术后腹压漏尿点压[(15.23±2.77)kPa]、最大尿流率时逼尿肌压[(10.01±1.57)kPa]、最大尿道闭合压[(9.77±1.54)kPa]、膀胱顺应性[(410.73±123.42)mL/kPa]均高于对照组[(9.34±2.31)kPa、(5.23±1.65)kPa、(6.50±1.72)kPa、(337.52±120.48)mL/kPa](P<0.05);观察组术后3、6、12个月Aa点[(-2.85±0.34)、(-2.24±0.31)、(-1.24±0.27)cm]和C点[(-6.82±0.39)、(-4.88±0.37)、(-3.49±0.42)cm]水平均低于对照组[(-1.02±0.52)、(-0.94±0.34)、(-0.85±0.22)cm,(-4.12±0.41)、(-3.75±0.36)、(-3.01±0.37)cm](P<0.05),Ⅰ类肌电位和Ⅱ类肌电位水平与对照组比较差异无统计学意义(P>0.05)。结论阴道骶骨固定术可明显改善女性尿动力。Objective To investigate the effect of sacrocolpopexy on female urodynamics and pelvic floor electrophysiology. Methods Fifty patients with pelvic organ prolapse were divided into observation group(n=30) and control group(n=20) according to the procedures. Observation group received sacrocolpopexy, and control group received traditional operation. Valsalva leak point pressure, detrusor pressure at maximum flow rate, maximal urethral closure pressure and bladder compliance were compared before and after operation. The electrophysiological changes of pelvic floor muscle were compared before as well as 3, 6 and 12 months after operation. Results The differences of pelvic organ prolapse quantification system score at Aa, Ba, C, Ap and Bp before and after operation were higher in observation group((5.01±0.42),(7.73±0.56),(12.79±0.41),(4.60±0.31),(5.09±0.67) cm) than those in control group((3.42±0.39),(6.13±0.53),(10.27±0.35),(3.34±0.27),(3.62±0.55) cm)(P<0.05). There were no significant differences in the valsalva leak point pressure, detrusor pressure at maximum flow rate, maximal urethral closure pressure and bladder compliance before operation between two groups(P>0.05). The levels of valsalva leak point pressure, detrusor pressure at maximum flow rate, maximal urethral closure pressure and bladder compliance were higher in observation group((15.23±2.77) kPa,(10.01±1.57) kPa,(9.77±1.54) kPa,(410.73±123.42) mL/kPa) than those in control group((9.34±2.31) kPa,(5.23±1.65) kPa,(6.50±1.72) kPa,(337.52±120.48) mL/kPa)(P<0.05). The Aa levels((-2.85±0.34),(-2.24±0.31),(-1.24±0.27) cm) and C levels((-6.82±0.39),(-4.88±0.37),(-3.49±0.42) cm) in observation group were lower than those in control group(Aa:(-1.02±0.52),(-0.94±0.34),(-0.85±0.22) cm;C:(-4.12±0.41),(-3.75±0.36),(-3.01±0.37) cm) in 3, 6 and 12 months(P<0.05). There was no significant difference in the value of the muscle potential of the pelvic floor type Ⅰ and type Ⅱ muscle fiber between two groups(P>0.05). Conclusion Sacrocolpope

关 键 词：盆腔器官脱垂 阴道骶骨固定术 尿动力学 盆底肌电生理 解剖复位 

分 类 号：R713[医药卫生—妇产科学]