改良盆底重建术与腹腔镜下阴道骶骨固定对盆腔脏器脱垂患者盆底功能、尿流动力学及生活质量的影响  

Effect of modified pelvic floor reconstruction and laparoscopic vaginal sacral fixation on pelvic floor function,urodynamics, and quality of life in patients with pelvic organ prolapse

作　　者：艾艳敏 吴飞 任满艳 AI Yan-min;WU Fei;REN Man-yan(Department of Obstetrics and Gynecology,Gucheng Hospital Affiliated to Hubei University of Arts and Science,Xiangyang 441700,Hubei,CHINA)

机构地区：[1]湖北文理学院附属谷城医院妇产科,湖北襄阳441700

出　　处：《海南医学》2022年第1期42-46,共5页Hainan Medical Journal

摘　　要：目的观察改良盆底重建术与腹腔镜下阴道骶骨固定对盆腔脏器脱垂(POP)患者盆底功能、尿流动力学及生活质量的影响。方法回顾性分析2018年1月至2020年3月期间在湖北文理学院附属谷城医院妇产科接受治疗的108例POP患者的诊疗情况。根据治疗方法的不同将患者进行分组,其中54例行改良盆底重建术者纳入对照组,54例行腹腔镜下阴道骶骨固定术者纳入观察组。比较两组患者的手术指标(手术时间、术中出血量、术后尿管置管时间及住院天数),随访6个月,比较两组患者术后并发症情况,以及术前、术后6个月的尿动力学参数、生活质量(采用盆底功能障碍问卷、性生活质量量表评价)、盆底功能[盆腔脏器脱垂症状调查表(POPDI-6)评分、结直肠肛门困扰量表(CRADI-8)评分、排尿困扰量表(UDI-6)评分]的变化。结果观察组患者的手术时间、术中出血量、术后尿管置管时间、住院天数分别为(93.55±27.45) min、(45.77±12.61) mL、(2.15±0.62) d、(3.27±0.86) d,明显少于对照组的(161.26±40.23) min、(70.35±20.13) mL、(2.96±0.52) d、(4.56±1.27) d,差异均有统计学意义(P<0.05);观察组和对照组患者的并发症总发生率分别为3.70%、5.56%,差异无统计学意义(P>0.05);术前,两组患者的最大尿流率、最大膀胱容量、平均尿流率及残余尿量比较差异均无统计学意义(P>0.05),术后6个月,两组患者的最大尿流率、最大膀胱容量及平均尿流率明显升高,且观察组的上述指标分别为(25.68±5.32) mL/s、(579.28±89.50) mL、(18.36±5.32) mL/s,明显高于对照组的(22.35±4.98) mL/s、(542.92±48.32) mL、(15.30±2.69) mL/s,残余尿量明显降低,且观察组为(10.26±2.38) mL,明显低于对照组的(15.62±2.68) mL,差异均有统计学意义(P><0.05);术前,两组患者的性生活质量及盆底生活质量比较差异均无统计学意义(P>0.05),术后6个月,两组患者的性生活质量及盆底生活质量评分Objective To observe the effect of modified pelvic floor reconstruction and laparoscopic vaginal sacral fixation on pelvic floor function, urodynamics, and quality of life in patients with pelvic organ prolapse(POP).Methods The diagnosis and treatment of 108 patients treated with POP in Department of Obstetrics and Gynecology,Gucheng Hospital Affiliated to Hubei University of Arts and Sciences from January 2018 to March 2020 were analyzed retrospectively. According to different treatment methods, 54 cases of modified pelvic floor reconstruction were included in the control group and 54 cases of laparoscopic vaginal sacral fixation were included in the observation group. The operation indexes(operation time, intraoperative bleeding, postoperative catheterization time and hospital stay) of the two groups were compared. The patients were followed up for 6 months. The postoperative complications, urodynamic parameters and quality of life(evaluated by pelvic floor dysfunction questionnaire and sexual life quality scale) were recorded and compared, and the pelvic floor function [Prolapse Distress Inventory-6(POPDI-6), Colorectal-Anal Distress Inventory-8(CRADI-8), and Urinary Distress Inventory-6(UDI-6)] were compared. Results The operation time, intraoperative bleeding, postoperative catheterization time, and hospital stay in the observation group were(93.55 ±27.45) min,(45.77±12.61) mL,(2.15±0.62) d,(3.27±0.86) d, respectively, which were significantly less than corresponding(161.26±40.23) min,(70.35±20.13) m L,(2.96±0.52) d,(4.56±1.27) d in the control group(all P<0.05). The total incidence of complications in the observation group was 3.70% versus 5.55% in the control group(P>0.05). There was no significant difference in the maximum urinary flow rate, maximum bladder volume, average urinary flow rate and residual urine volume between the two groups before operation(all P>0.05);after 6 months of operation, the maximum urinary flow rate, maximum bladder volume, and average urinary flow rate of the two groups

关 键 词：盆腔脏器脱垂 改良盆底重建术 腹腔镜下阴道骶骨固定 盆底功能 尿流动力学 生活质量 

分 类 号：R711.2[医药卫生—妇产科学]