阴道全封闭术治疗老年女性盆腔器官脱垂的疗效  

Efficacy of total colpocleisis in treatment of pelvic organ prolapse in elderly women

作　　者：陈永连[1] 郑玉华[1] 王玉玲[1] 肇丽杰[1] CHEN Yong-Lian;ZHENG Yu-Hua;WANG Yu-Ling;ZHAO Li-Jie(Department of Gynecology, Foshan Maternal and Child Health Hospital, Foshan 528000, Guangdong Province, China)

机构地区：[1]佛山市妇幼保健院妇科,广东佛山528000

出　　处：《中华老年多器官疾病杂志》2021年第2期123-126,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的分析老年女性盆腔器官脱垂(POP)患者实施阴道全封闭术的临床疗效及安全性。方法选取2012年1月至2018年1月在佛山市妇幼保健院妇科住院治疗、盆腔器官脱垂分期法(POP-Q)评定为Ⅲ~Ⅳ期、并接受阴道全封闭术治疗的78例老年POP患者。所有患者治疗后进行1年随访观察,记录术前和术后POP-Q分期情况。分析患者盆腔症状及患者满意度情况。采用盆底功能障碍量表(PFDI-20)[包括尿失禁困扰量表(UDI-6)、结-直肠肛门困扰量表(CRADI-8)、盆腔脏器脱垂量表(POPDI-6)]及盆底功能障碍影响量表(PFIQ-7)对患者术前和术后生活质量进行评价。采用χ2检验对手术前后患者的盆腔器官脱垂症状等进行比较;采用t检验对患者手术前后的生活质量评分结果进行比较。结果1例患者术后复发(≥Ⅱ期),总体疗效为98.71%(≤Ⅰ期)。POP患者外阴肿物脱出、盆腔坠胀感、尿频尿急症状、排尿困难、压力性尿失禁、排便困难等盆腔器官脱垂症状术后较术前明显减少,差异有统计学意义(P<0.05);患者术后主观满意度为100%。PFDI-20(UDI-6、CARDI-8、POPDI-6)和PFIQ-7量表评分术后较术前明显降低,差异有统计学意义(P<0.05)。结论对老年POP患者实施阴道全封闭术可显著降低患者的POP-Q分期及改善盆腔症状,术后患者满意度高,生活质量提高。Objective To investigate the efficacy and safety of total colpocleisis in treatment of elderly women with pelvic organ prolapse(POP).Methods A total of 78 elderly women with POP quantification(POP-Q)stage ofⅢ-Ⅳundergoing total colpocleisis in gynecologic department of Foshan Maternal and Child Health Hospital from January 2012 to January 2018 were recruited in this study.All patients were followed up for 1 year,and preoperative and postoperative POP-Q stages,pelvic symptoms and satisfaction were recorded and analyzed.Preoperative and postoperative quality of life were evaluated using the pelvic floor distress inventory short form-20(PFDI-20)[including urinary distress inventory-6(UDI-6),colorectal-anal distress inventory-8(CRADI-8),pelvic organ prolapse distress inventory-6(POPDI-6)]and pelvic floor impact questionnaire-7(PFIQ-7).Chi-square test was used to compare the preoperative and postoperative POP symptoms,and student′s t test was applied to compare the life quality between preoperation and post-operation.Results The overall efficacy was 98.71%(≤stageⅠ),and 1 case experienced recurrence(≥stageⅡ).POP symptoms,such as vulvar mass prolapse,pelvic distension,frequent urination and urgent to urinate,dysuria,stress urinary incontinence,and defecation difficulty were significantly reduced postoperation(P<0.05).The subjective satisfaction was 100%.The points of PFDI-20(UDI-6,CRADI-8,POPDI-6)and PFIQ-7 preoperatively were significantly lower than those preoperatively,with statistical differences(P<0.05).Conclusion Total colpocleisis can significantly decrease the POP-Q stage and pelvic symptoms,and obtain postoperative satisfaction and quality of life in elderly POP patients.

关 键 词：老年人 阴道全封闭术 盆腔器官脱垂 临床疗效 生活质量 

分 类 号：R713.3[医药卫生—妇产科学]