改良LeFort阴道封闭术与改良全盆底重建术治疗老年女性重度盆腔器官脱垂的效果  

Efficacy of modified LeFort colpocleisis and modified total pelvic floor reconstruction in the treatment of severe pelvic organ prolapse in elderly women

作　　者：段焕鑫 庄雅丽[1] DUAN Huanxin;ZHUANG Yali(Department of Comprehensive Gynecology,Anhui Province Maternity&Child Health Hospital Affiliated to Anhui Medical University,Anhui,Hefei 230000,China)

机构地区：[1]安徽医科大学附属妇幼保健院综合妇科,安徽合肥230000

出　　处：《中国医药科学》2023年第1期115-118,共4页China Medicine And Pharmacy

基　　金：安徽省合肥市卫生健康应用医学研究项目(合卫科教〔2019〕172号);安徽省妇幼保健院科研项目(zd2021-2-3)。

摘　　要：目的比较改良LeFort阴道封闭术与改良全盆底重建术治疗老年重度盆腔器官脱垂的临床效果。方法回顾性分析2014年1月至2020年12月在安徽医科大学附属妇幼保健院实施改良LeFort阴道封闭术的30例患者(研究组)与改良全盆底重建术的66例患者(对照组)的临床资料和术后随访情况。结果两组患者围手术期指标比较,差异无统计学意义(P>0.05)。两组患者术后PFDI-20、PFIQ-7评分较术前均降低,差异有统计学意义(P<0.05),组间比较差异无统计学意义(P>0.05)。两组患者的治愈率、复发率、新发压力性尿失禁率、再次手术率比较,差异无统计学意义(P>0.05)。研究组术后尿路症状与术前比较,差异无统计学意义(P>0.05),肛门直肠症状与术前比较,差异有统计学意义(P<0.05);对照组术后尿路症状、肛门直肠症状与术前比较,差异有统计学意义(P<0.05);组间比较差异无统计学意义(P>0.05)。结论两种术式均安全有效,改良LeFort阴道封闭术后因性功能的丧失患者可能出现后悔的情况,并且对尿路症状改善效果欠佳。改良全盆底重建术导致网片暴露的问题及需要再次手术的情况不容忽视。Objective To compare the clinical efficacy of modified LeFort colpocleisis and modified total pelvic floor reconstruction in the treatment of severe pelvic organ prolapse in elderly women.Methods The clinical data and postoperative follow-up of patients admitted to the Department of Comprehensive Gynecology of Anhui Province Maternity&Child Health Hospital Affiliated to Anhui Medical University from January 2014 to December 2020 were retrospectively analyzed.They were divided into the study group(n=30)and the control group(n=66).The study group was treated with modified LeFort colpocleisis,while the control group was treated with modified total pelvic floor reconstruction.Results There were no statistically significant differences in perioperative data between the two groups of patients(P>0.05).After operation,the scores of PFDI-20 and PFIQ-7 in the two groups of patients were both lower than those before operation,with statistically significant differences(P<0.05),while there were no statistically significant differences between the two groups(P>0.05).There were no statistically significant differences in the recovery rate,relapse rate,new stress urinary incontinence rate and reoperation rate between the two groups of patients(P>0.05).In the study group,there was no statistically significant difference in the urinary tract symptoms before and after operation(P>0.05).While in the anorectal symptoms,there was statistically significant difference before and after operation(P<0.05).In the control group,there were statistically significant differences in the urinary tract symptoms and anorectal symptoms before and after operation(P<0.05).However,there were no statistically significant differences in urinary tract symptoms and anorectal symptoms between the two groups after surgery(P>0.05).Conclusion Both methods are safe and effective.After modified LeFort colpocleisis,there may be regrets due to the loss of sexual function,and the effect of improving urinary tract symptoms is not good.The problem of mesh exposure ca

关 键 词：盆腔器官脱垂 改良LeFort阴道封闭术 改良全盆底重建术 网片暴露 

分 类 号：R713[医药卫生—妇产科学]