硅胶子宫托用于女性盆腔器官脱垂的疗效分析

目的探讨硅胶子宫托治疗女性盆腔器官脱垂的临床效果及生活质量改善情况。方法对2009年9月至2012年5月硅胶子宫托保守治疗POP-QⅢ~Ⅳ期盆腔器官脱垂72例患者进行随访,填写盆底功能障碍问卷简表（PFDI-20）和盆底功能影响问卷简表（PFIQ-7）,评价子宫托治疗的疗效。结果 72例盆腔器官脱垂患者中,1例为全盆腔重建术后复发。随访时间24~50个月,平均随访时间（30.71±5.49）个月。13例失访,59例完成随访,随访率为81.94%。59例患者中,35例（59.32%）效果显著,持续佩戴,取放间隔时间为1~4周;24例（40.68%）在3个月内放弃使用子宫托,其中取放困难11例（45.83%）,长期佩戴有不适感8例（33.33%）,易脱落4例（16.67%）,1例83岁患者因偏瘫长期卧床放弃使用。35例患者治疗前PFDI-20和PFIQ-7评分分别为（46.94±36.10）分和（98.23±48.01）分,治疗后6个月分别下降至（6.07±15.63）分和（14.56±11.14）分,治疗后2年分别下降为（3.72±12.76）分和（5.3±4.87）分,与治疗前比较,差异均有统计学意义（P均〈0.05）。结论子宫托可以有效改善盆腔器官脱垂患者的症状,提高生活质量,适合门诊广泛开展应用。

Clinical application and efficacy of silicone pessary treatment on female pelvic organ prolapse

Objective To explore the clinical application and improving of life quality of silicone pessary for female pelvic organ prolapse（POP）patients.Methods The 72 POP patients pelvic organ prolapse（POP-Q stageⅢ~Ⅳ）treated with silicone pessary from September 2009 to May 2012 in our hospital recruited in this study.All patients filled in the questionnaire（PFDI-20;PFIQ-7）,the effects of pelvic floor dysfunction were evaluate.Results 1of the 72 patients were recurrence after total pelvic floor reconstruction.The follow up time was 24 to 50months.The median follow-up time was（30.71±5.49）months.13 cases failed to follow-up due to death or lost contact.The follow-up rate was 81.94%.35（59.32%）cases took the pessary effectively in long term,changed them every 1to 4weeks.24（40.68%）cases gave up using pessary in 3months,including 11（45.83%）cases with fetching difficulty,8（33.33%）cases with feeling of discomfort,4（16.67%）cases easy to fall off,and a 83 years old patient with paralysis and fail to using pessary.There were 35 patients completed PFDI-20 and PFIQ-7questionnaires.Before silicone pessary treatment,PFDI-20 and PFIQ-7scores in patients were 46.94±36.10,98.23±48.01,the scores decreased to 6.07±15.63 and 14.56±11.14 after 6monthstreatment,and after 2yearstreatment the scores were decreased significantly（3.72±12.76 vs 5.3±4.87,P〈0.05）.Conclusions Pessary is a effective therapy for POP patients,it can improving the life quality without serious complications after long-term use.The pessary should be used widely in POP patients.