PROSIMA修复系统在盆腔器官脱垂患者中的应用及疗效分析

目的通过PROSIMA盆底重建手术治疗症状性Ⅱ～Ⅲ期盆腔器官脱垂（pelvic organ prolapse,POP）,旨在寻找一种治疗POP的理想手术方式。方法对2010年9月至2011年12月郑州大学第一附属医院32例症状性POP-QⅡ～Ⅲ期盆腔器官脱垂患者施行PROSIMA修复系统盆底重建手术,采用盆底功能障碍影响问卷简要版（PFIQ-7）和盆腔器官脱垂/尿失禁性功能问卷（PISQ-12）评价其效果,并分析手术并发症情况。结果 32例患者症状均缓解,手术成功率为100%,术中平均出血量为（40.4±13.7）ml,平均手术时间为（65.1±33.5）min,无血管、神经、膀胱及肠道损伤。平均随访时间为（10.1±9.2）个月（3～18个月）,无不适、感染及排异情况。2例补片暴露,对症治疗。无新发急迫性及压力性尿失禁。术后3个月PFIQ-7评分（21.4±21.2）分较术前（69.1±21.6）分]明显降低（P〈0.05）。20例患者术后有性生活,术后3个月PISQ-12评分（26.7±11.7）分]较术前（81.3±12.6）分]明显降低（P〈0.05）。结论 PROSIMA修复系统盆底重建手术创伤小、出血少、安全可行,近期疗效好,但其远期疗效及患者性生活质量有待进一步随访。

The clinical application and the effect of PROSIMA repair system in treating pelvic organ prolapse

Objective To evaluate the effect of PROSIMA repair system in treating symptomatic moderate to severe pelvic organ prolapse(POP).Methods 32patients with POP(stageⅡ～Ⅲ)who underwent PROSIMA pelvic floor reconstruction form Sep,2010to Dec,2011were followed up.The clinical outcome and complications were anylazed.Reaults The average blood loss was(40.4±13.7)ml(20～50ml),the average operation time was(65.1±33.5)min (50～90min).No blood vessels and nerves damage,no bladder and bowel injury occurred during operation.After 3to 18months follow-up,the anatomic success was 100%.There was one mesh erosion and was cured after outpatient treatment.No postoperative complications ourred such as infection and rejection,physical pain and feeling motor dysfunction.Ten patients who recovered sexual activity didn’t complain of dyspareunia,no de novo urgency incontinence and stress urinary incontinence occurred.The scores for PFIQ-7and PISQ-12were signif-icantly improved,the scores of before treatment were lower than those after treatment(P<0.05).Conclusions PROSIMA pelvic floor reconstruction is an effective surgical method for treating POP with less invasive.The long-term effect and life quality after this procedure need further followed-up.