前盆底重建术治疗女性前盆腔脏器脱垂的疗效分析

目的探讨采用Gynecare Anterior Prolift系统进行前盆底重建术治疗前盆腔脏器脱垂疾病的疗效及安全性。方法对42例患有POP分期Ⅲ期或Ⅳ期的生殖器官脱垂患者（5例合并轻度压力性尿失禁，22例合并不同程度的高血压、心脏病、糖尿病、呼吸系统疾病）回顾性分析行前盆底重建术术中及术后的恢复情况、并发症和临床疗效，并随访其复发率及生活满意度。结果42例前盆腔缺陷患者的A—prolift手术治疗过程顺利，总手术时间平均为50．6min（40—70min）。补片放置时间平均为17min。术中出血量平均为200ml（150—280m1）。术中未发生膀胱、血管、神经损伤。术后无患者转入ICU，术后恢复良好。平均住院天数6．6d（5～11d），42例患者平均随访8个月（1个月至14个月），1例于术后3月时出现网片侵蚀现象，2例发生阴道流液现象，客观治愈率为100％，主观治愈率为100％，未有复发。未有患者诉性交不适。5例合并压力性尿失禁的患者症状消失。结论A—prolift可以有效治疗前盆腔脏器脱垂患者，安全可行，且对轻度压力性尿失禁的患者具有良好的治疗效果，但长期疗效有待进一步的观察。

Clinical effects of anterior pelvic floor reconstruction(A-prolift)in the treatment of anterior pelvic organ prolapse

Objective To analyze the outcomes of 42 cases with anterior pelvic defects treated with'Gyne care Anterior Prolift System and to discuss the efficacy and safety of this system．Methods The complications of Aprolift operations,postoperative chnical efficacy and recovery,were Retrospectively analyzed and followed up the recunence rate and life satisfaction level among 42 pelvic organ prolapse patients who were staged as grade Ⅲ or Ⅳ according to POP-Q quantification from January 2008 to April 2009．Among these 42 cases,5 cases complicated with mild stress urinary incontinence,while 22 cases had different level of hypertension,cardiac disease,diabetes and respiratory diseases．Results A-prolift operations were carried out successfully in all 42 cases,with an average operation duration 50．6 min(40～70 min),average time for mesh placement was 17 min and average blood loss 200 ml (150～280 m1)．No injuries of bladder,blood vessels or nerve occurred．And also there was no ICU transference．The average hospitalization was 6．6 days(5～11 days),postoperation follow-up lasted about 1 month to 14 months,with an average of 8 months．Mesh erosion occurred in 1 case which quickly healed after local sterilization and removal of extra mesh．While increasing vaginal disacharge occurred in 2 cases and were relieved after cutting off the thread ends,which were assumed to be caused by malabsorption of thread．The outcomes proved to he satisfactory with 100％ of objective and subjective recovery rates,no complaint of dyspareunia and disappearance of incontinence symptoms in 5 cases who previously had SUI．Conclusion A-prolift is an effective,safe and pplicable treatment for anterior pelvic defects．as well as mild SUI．While long-term efficacy needs further study．