Prolift系统盆底重建术的临床疗效及对患者生活质量的影响

目的研究女性Prolift系统盆底重建术的临床疗效及对患者生活质量的影响。方法回顾性分析2007年1月至2010年6月因重度盆腔器官脱垂（POP）在北京大学人民医院妇科接受Prolift系统进行盆底重建手术治疗的98例患者的资料,通过比较患者术前、术后POP-Q分期、盆底功能影响问卷-简表7（PFIQ-7）、盆底功能障碍问卷-20（PFDI-20）及性生活质量问卷-31评分情况,评价Prolift盆底重建系统在妇科的应用价值。结果 98例患者中83例患者按时随访并回收问卷,平均随访时间（34.07±23.43）个月。患者平均手术时间（82.34±26.78）min;平均术中出血量（109.06±70.45）ml。无术中严重并发症。解剖治愈率87.95%（73/83）。脱垂复发10例（12.05%）,补片侵蚀7例（8.43%）,盆腔血肿4例（4.82%）。术前合并压力性尿失禁（SUI）37例患者同时行抗尿失禁手术,术后SUI症状消失33例（89.19%）,而术前无SUI的患者中术后有14.29%出现了SUI。调查问卷显示,患者术后生活质量有明显改善,但术前、术后性生活质量比较,差异无统计学意义（P〉0.05）。结论应用Prolift行盆底重建术可明显提高患者的生活质量,复发率较传统手术低。术后新发SUI应引起重视。远期效果还需长期随访。

Clinical effect and quality of life after Prolift procedure

Objective To investigate the clinical effect and quality of life(QOL) of patients with pelvic organ prolapse(POP) after ProliftTMsystem.Methods Data of 98 POP patients who underwent Prolift procedure from January 2007 to June 2010 in Peking University People’s Hospital was studied retrospectively.The anatomic outcome was investigated by recurrence rate of prolapse and POP-Q,the QOL was by PFIQ-7 and PFDI-20.The sexual life quality was evaluated with PISQ-31.Results 83 patients completed the entire study with the mean follow up time(34.07±23.43) months.The average operation time and blood loss was(82.34±26.78) minutes and(109.06±70.45) ml.Anatomic success was 87.95% and the erosion rate was 8.43%,4 cases of pelvic hematoma occured(4.82%).De novo stress urinary incontinence(SUI) rate was 14.29%.QOL occurs was significantly improved while sexual life quality had no change after Prolift procedure.Conclusions The Prolift procedure is an effective surgical method for treating POP,and may improve the quality of life.De novo SUI may be very common after Prolift procedure.