两种全盆底重建术后患者生活质量的初步研究

目的 观察两种全盆底重建术对患者生活质量的影响.方法 应用Prolift盆底悬吊系统行全盆底重建术14例(Prolift组),应用Gynemesh聚丙烯补片行改良全盆底重建术17例(Gynemesh组).两组患者体重指数、绝经年龄和孕次比较,差异无统计学意义(P＞0.05),Prolift组患者年龄[(63±9)岁]、产次[(1.9±1.1)次]均低于Gynemesh组[(69±5)岁、(3.1±1.1)次],差异均有统计学意义(P＜0.05).手术前后进行生活质量调查问卷评分.结果 (1)术前评分:Prolift组盆底功能影响评分为(91±42)分、盆底功能障碍评分为(100±59)分、性生活评分为(77±26)分;Gynernesh组盆底功能影响评分为(65±56)分、盆底功能障碍评分为(89±73)分、性生活评分为(75±18)分,两组各项评分比较,差异均无统计学意义(P＞0.05);(2)术后评分:Prolift组盆底功能影响评分为(7±15)分、盆底功能障碍评分为(27±24)分、性生活评分为(79±43)分,Gynemesh组盆底功能影响评分为(13±24)分、盆底功能障碍评分为(24±21)分、性生活评分为(74±15)分,两组各项评分比较,差异也无统计学意义(P＞0.05).结论 Prolift全盆底重建术和Gynemesh改良全盆底重建术术后的生活质量均有明显改善,而在术后性生活质量改善方面,Prolift全盆底重建术效果更好.

Clinical observation on quality of life of two different operative methods of total pelvic floor reconstruction

Objective To compare patients' quality of life followed by Prolift operation and the revised total pelvic floor reconstruction with Gynemesh.Methods Thirty one patients underwent total pelvic floor reconstruction surgery were divided into two groups,including 14 cases treated by Prolift surgery and 17 cases treated by the revised total pelvic floor construction with Gynemesh.The body weight index(BWI),menopausal age and gravidity history did not show significant difference between two groups(P ＞0.05).The patients' age with 63±9 in Prolift group was significantly lower than 69±5 in Gynemesh group (P ＜0.05).Questionnair score of quality of life were collected and evaluated pre-and post-operation.Result (1) Preoperative scores:there was no significantly different scores of the following index between two groups (P ＞0.05),which were 91±42 in pelvic floor impact query,100±59 in pelvic floor distress query and 77±26 in sexual life query in Prolift group,65±56 in pelvic floor impact query,89±73 in pelvic floor distress query and 75±18 in sexual life query in Gynemesh group.(2) Postoperative scores:similarly,there was also no significantly different scores in the following index between two groups (P ＞ 0.05),which were 7±15 in pelvic floor impact query,27±24 in pelvic floor distress query and 79±43 in sexual life query in Prolift group,13±24 in pelvic floor impact query,24±21 in pelvic floor distress query and 74±15 in sexual life query in Gynemesh group.Conclusions The patients' quality of life were improved after Prelift operation and the revised total pelvic floor construction with Gynemesh.However,about quality of sexual life,Prolift operation did much better than revised pelvic surgery with Gynemesh.