经阴道植入TiLOOP Total 6网片的盆底重建术在盆腔器官脱垂的效果评价  

Evaluation of the Effect of Pelvic Floor Reconstruction Using Transvaginal TiLOOP Total 6 Mesh in Patients with Pelvic Organ Prolapse

作　　者：娄吉成 黄欢 LOU Jicheng;HUANG Huan(Department of Gynecology and Obstetrics,Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Key Laboratory for Molecular Diagnosis of Hubei Province,Wuhan Hubei 430014,China)

机构地区：[1]华中科技大学同济医学院附属武汉中心医院妇产科、分子诊断湖北省重点实验室,湖北武汉430014

出　　处：《实用妇产科杂志》2025年第3期210-215,共6页Journal of Practical Obstetrics and Gynecology

基　　金：武汉市卫生健康委员会青年重点项目(编号:WX20A05)。

摘　　要：目的:评价经阴道植入TiLOOP Total 6网片的盆底重建术联合会阴体重建术及阴道后壁修补术在盆腔器官脱垂(POP)的治疗效果及安全性。方法:收集2022年1月至2023年3月于华中科技大学同济医学院附属武汉市中心医院因Ⅲ~Ⅳ度POP行手术治疗的52例患者资料,分析围手术期指标、手术并发症,评估患者总体印象改善(PGI-I)评分量表、主客观治愈率,比较术前和术后12个月盆腔器官脱垂定量分度法(POP-Q)指示点的复位情况,并评价患者的生活质量。结果:52例患者手术均顺利完成,术中无血肿形成、无膀胱及直肠损伤,手术时间120±18 min,术中出血量141±44 ml,下肢深静脉血栓发生率5.7%(3/52),术后24 h视觉模拟评分法(VAS)评分中重度疼痛占比53.8%(28/52)。随访至术后12个月,手术成功率为100%,网片暴露率3.8%(2/52),新发压力性尿失禁发生率3.8%(2/52),主客观治愈率均为100%,POP-Q各指示点较术前均有显著提升(P<0.0001),盆底不适调查表简表20、盆底障碍影响简易问卷7、盆腔器官脱垂/尿失禁性功能问卷12评分与术前比较均有明显改善(P<0.0001)。PGI-I评分显示52例患者均主观满意。结论:经阴道植入TiLOOP Total 6网片的盆底重建术联合会阴体重建术及阴道后壁修补术是一种安全、有效的手术方式,对于Ⅲ~Ⅳ度的POP的患者短期治疗效果确切,患者的主观满意度高。Objective:To evaluate the efficacy and safety of pelvic floor reconstruction using TiLOOP Total 6 mesh combined with perineal body reconstruction and posterior vaginal wall repair in patients with pelvic organ prolapse(POP).Methods:A retrospective analysis was conducted on 52 patients diagnosed with stageⅢ-ⅣPOP who underwent surgical intervention at Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology between January 2022 and March 2023.The perioperative indicators and surgical complications were evaluated.The patient global impression of improvement(PGI-I),subjective and objective cure rates were evaluated.The POP-Q points before and 12 months after surgery were compared.Postoperative quality of life was also assessed.Results:All procedures were successfully completed without intraoperative complications.No intraoperative hematomas or injuries to the bladder and rectum were documented.Mean operative duration was 120±18 min,with an intraoperative blood loss of 141±44 ml.Postoperative complications included venous thromboembolism(5.7%,3/52)and moderate-to-severe pain(53.8%,28/52).Until the follow-up period of 12 months,the surgical success rate was 100%.Mesh exposure rate and new stress urinary incontinence rate were 3.8%(2/52).The subjective and objective cure rate were 100%.Furthermore,POP-Q index points at the time of 12 months after operation were significantly improved compared with preoperative(P<0.0001).PFDI-20,PFIQ-7 and PISQ-12 scales were also significantly improved after the operation(P<0.0001).Patient satisfaction,as reflected by PGI-I scores,was unanimously positive.Conclusions:Pelvic floor reconstruction using TiLOOP Total 6 mesh combined with perineal body reconstruction and posterior vaginal wall repair is a safe and effective procedure for patients with advanced-stage POP(Ⅲ-Ⅳ),achieving high patient satisfaction.

关 键 词：盆腔器官脱垂 TiLOOP网片 聚丙烯网片 盆底重建术 

分 类 号：R711.2[医药卫生—妇产科学]