改良盆底重建术治疗盆腔器官脱垂的临床研究

目的:探讨改良盆底重建术治疗盆腔器官脱垂(POP)的临床实用性。方法:选取59例POP患者,其中19例采用改良盆底重建术(A组),20例采用阴式子宫全切除术+阴道前壁"斜拉桥"式修补术(B组);20例采用传统阴式子宫全切除术+阴道前壁修补术(C组)。比较3组患者的围手术期各项指标情况及术后复发、阴道深度、性生活保持情况及疼痛不适等并发症情况。结果:(1)3组患者的手术时间、术中出血量、术后病率、术后性生活保持率及术后随访主观复发率比较差异均无统计学意义(P0.05);3组的术后留置尿管时间及客观复发率两两比较差异均有统计学意义(P0.05),A组的留置尿管时间最短,C组的客观复发率较高。C组术后的平均阴道深度浅于A、B组,差异有统计学意义(P=0.000);但后两组比较差异无统计学意义。3组患者均无严重并发症发生。结论:3种术式均能短期内解决POP问题,改良盆底重建术术式简单易操作,可保持盆底结构及功能的完整性,短期内具有较好的疗效,但远期疗效尚待循证。

A clinical study of surgical treatment of pelvic organ prolapse using a modified pelvic floor reconstruction surgery

Objective: To explore the clinical value of the modified pelvic floor reconstruction surgery in treating Pelvic Organ Prolapse( POP). Methods: 59 POP cases were selected,of which 19 cases used the modified pelvic floor reconstruction surgery,group A cases; 20 cases received the transvaginal hysterectomy + anterior cable-stayed bridge colporrhaphy,group B cases; and another 20 cases adopted traditional transvaginal hysterectomy + anterior colporrhaphy,group C cases. We then evaluated the above three groups of patients in the following aspects such as perioperative clinical data,postoperative recurrence,vaginal depth,retention of sex life,and surgery complications such as painful discomfort,etc. Results: Concerning the three above-mentioned methods of operation,there is no statistical difference( P > 0. 05) with regards to time of surgery,perio-operative bleeding amount,the rate of postoperative fever,the rate of sex life retention after the surgery,and the subjective postoperative recurrence rate known after follow-up visits; There appears statistical significance in respect of time for indwelling urinary catheter in these three groups of operation,It was A cases wich need shortest time of retaining a urinary catheter; C cases incurs a higher recurrence rate at the objective postoperative recurrence rate than A and B cases,as for the vaginal depth average after the operation,C cases is more lower than other two groups( P = 0. 000),while,in case of the A cases vs the B cases no statistical difference can be noticed. As for the postoperative complications,the three fore-said surgical procedures cause no severe complications. Conclusions: In the short run,these three operations are capable of solving the problems caused by POP. The modified pelvic floor reconstruction surgery's procedure is easy to operation,it can help patients regain integrity of anatomical structure and functions of pelvic floor and it has good curative effect in the short term,the long-term curative effect is yet to be evidence-based.