重度盆腔器官脱垂患者治疗选择及影响因素

目的 探讨影响重度盆腔器官脱垂患者选择治疗方式的相关因素。 方法 选取2020年12月至2022年3月期间因重度盆腔器官脱垂就诊的患者为研究对象(n=145),根据患者意愿分为手术组(n=78)和子宫托组(n=67)。比较两组一般临床资料、自我身体形象评价量表(MBIS)评分及盆底障碍量表简表(PFDI-20)评分,采用单因素分析和二分类Logistic回归分析探讨影响重度盆腔器官脱垂患者选择治疗方式的相关因素。 结果 手术组与子宫托组比较,体质量指数(BMI)、就诊年龄、患病年限、中盆腔器官脱垂定量分期、合并症、MBIS评分及泌尿生殖影响量表简表(UDI-6)评分差异均有统计学意义(P<0.001,P=0.036,P<0.001,P<0.001,P=0.005,P<0.001,P<0.001)。Logistic回归多因素分析显示,就诊年龄、患病年限、中盆腔器官脱垂定量分期、合并多种内科疾病、MBIS评分及UDI-6评分为重度盆腔器官脱垂患者选择不同治疗方式的独立影响因素(P=0.006,P=0.005,P=0.019,P=0.009,P=0.001,P=0.023)。 结论 就诊年龄较大、患病年限较长、中盆腔器官脱垂分期较高、自我身体形象评价较低以及下尿路症状明显的患者更倾向于选择手术治疗,而合并多种内科疾病的患者通常选择子宫托治疗。

Influencing factors of the choice of treatment for patients with severe pelvic organ prolapse

Objective To explore factors influencing the selection of treatment strategy for patients with severe pelvic organ prolapse(POP). Methods A total of 145 patients with severe POP treated during Dec. 2020 and Mar. 2022 were selected and divided into the surgical group(n=78)and pessary group(n=67)according to the treatment strategy. The general information, scores of the modified body self-image scale(MBIS), scores of pelvic floor distress inventory short form(PFDI-20), and scores of urogenital distress inventory short form(UDI-6)were compared between the two groups. Factors influencing the selection of treatment strategies were analyzed with univariate and binary Logistic regression analyses. Results Statistically significant differences were found in body mass index(BMI), age of initial visit, course of illness, mid-pelvic POP-Q stage, complications, MBIS scores and UDI-6 scores between the two groups(P<0.001, P=0.036, P<0.001, P<0.001, P=0.005, P<0.001, P<0.001). Logistic regression showed that age of initial visit, course of illness, mid-pelvic POP-Q stage, complications, MBIS scores and UDI-6 scores were independent factors influencing the choice of different treatment modalities(P=0.006, P=0.005, P=0.019, P=0.009, P=0.001, P=0.023). Conclusion Patients who visit the clinic at an older age, have a long course of disease, severer mid-pelvic POP-Q stage, lower MBIS scores and lower urinary tract symptoms are more likely to choose surgery, while patients complicated with other diseases like to choose pessary.