改良盆底重建术治疗盆腔脏器脱垂临床疗效观察

目的观察改良盆底重建术和经阴道子宫切除术加阴道前后壁修补术治疗盆腔脏器脱垂性疾病的效果。方法回顾性分析2006年1月～2011年12月106例POP患者的临床资料,其中传统组58例行阴式子宫切除加阴道前后壁修补术,重建组48例行改良盆底重建术,比较两组手术时间、术中出血、排气时间、术后住院时间及疗效等情况。结果重建组手术时间、术中出血、排气时间、术后住院时间分别是(95.0±34.0)min、(157.1±65.7)mL、(23.5±6.5)h、(4.8±1.7)d;传统组分别为(115.0±39.3)min、(177.5±115.1)mL、(48.6±5.8)h,(5.1±1.8)d,两组手术时间和排气时间差异均有统计学意义(P<0.05)。重建组及传统组总有效率分别为95.83%和84.48%,重建组明显优于传统组(P<0.05)。结论经阴道子宫切除术加阴道前后壁修补术和改良全盆底重建术均是治疗POP的有效方法。改良盆底重建术能更好地修补盆腔组织缺陷,实现结构组织重建和替代,短期疗效稳固。

Clinical analysis on modified pelvic floor reconstruction in treating female pelvic organ prolapse

Objective To investigate the clinical significance of modified pelvic floor reconstruction and transvaginalhysterectomy plus repairofvaginalanteriorand posterior wall on the treatment of pelvic organ prolapse(POP)。 Methods Of the 108 cases of POP,38 were performed vaginal hysterectomy plus colporrhaphia anterior-posterior(tradition group) and 18 ofmodified pelvic floor reconstruction(reconstruction group.from June 2006 toFebruary 2012 The clinical parameterswere observedand analyzed.Results The operation time,blood loss,recovery time of postoperative gastrointestinal function,mean in-hospital time(95.0±34.0)min,(157.1±65.7)mL(23.5±6.5)h,(4.8±1.7) d in the reconstruction group,and(115.0±39.3)min,(177.5±115.1)mL(48.6±5.8)h,(5.1±1.8)d in the traditiongroup,respectively.The operation time and recovery time of postoperative gastrointestinal function had significant differences between the two groups(P < 0.05).The total effective rates in the reconstructiongroup and tradition group were 95.83% and84.48%,respectively.The differencewas significantbetween the two groups(P < 0.05).Conclusion Transvaginalhysterectomy plus repair ofvaginal anterior and posteri-orwallof POP andmodified totalpelvic floor reconstruction are both effectiveways in the treat-mentofPOP.As a new surgical technique,modified total pelvic floor reconstruction repairs thedefects and realizes the structural reconstruction and tissue replacementmore effectively,and with lower recurrence rate,but the long-term effect need further observation.