盆底悬吊术治疗盆底功能障碍性疾病临床效果及远期复发率观察

目的探讨盆底悬吊术治疗盆底功能障碍性疾病(PFD)临床效果和对远期复发率的影响,为提高患者生活质量和性生活质量提供有效的治疗方法。方法选取PFD患者76例根据治疗方法分组,将行盆底悬吊术的40例患者作为观察组,行阴式子宫切除加阴道前后壁修补术的36例患者作为对照组,两组患者术后1个月均给予盆底康复治疗仪治疗。对比两组围手术期指标、术后并发症发生情况、术后肌电水平和分度指示点及术后6个月和12个月时患者生活质量、性生活质量、压力性尿失禁和盆腔脏器脱垂复发率。结果观察组患者围手术期指标均优于对照组患者,差异有统计学意义(P<0. 01)。观察组患者术后并发症发生率15. 00%与对照组患者的22. 22%差异无统计学意义(P>0. 05)。观察组患者术后分度指示点指标优于对照组患者,差异有统计学意义(P<0. 05);两组治疗后的肌电水平均较术前显著改善,差异有统计学意义(P<0. 01),但组间比较差异无统计学意义(P>0. 05)。术后6个月、12个月观察组PFIQ-7评分、PFDI-20评分和PISQ-12评分均显著低于对照组,差异有统计学意义(P<0. 05);术后6个月的压力性尿失禁和盆腔脏器脱垂复发率两组差异无统计学意义(P>0. 05);术后12个月时观察组压力性尿失禁和盆腔脏器脱垂复发率显著低于对照组,差异有统计学意义(P<0. 05)。结论盆底悬吊术治疗PFD效果确切,可显著减少术后并发症,恢复患者术后盆底组织肌力,减少远期复发率,提高患者生活质量和性生活质量。

Clinical effect of pelvic floor suspension in treatment of pelvic floor dysfunction and observation on the long-term recurrence rate

Objective To explore the clinical effect of pelvic floor suspension in treatment of pelvic floor dysfunction(PFD) and the impact on long-term recurrence rate,provide an effective treatment method for improving life quality and sexual life quality.Methods Seventy-six PFD patients were selected and divided into two groups according to treatment methods:40 patients in observation group were treated by pelvic floor suspension,and 36 patients in control group were treated by transvaginal hysterectomy,vaginal anterior and posterior wall repair.The patients in the two groups were treated by pelvic floor rehabilitation therapeutic apparatus after one month.The perioperative indicators,postoperative complications,postoperative myoelectricity levels and index points,life quality,sexual life quality,recurrence rates of stress urinary incontinence and pelvic organ prolapse at 6 and 12 months after surgery in the two groups were compared.Results The perioperative indexes in observation group were statistically significantly better than those in control group(P<0.01).The incidence rates of postoperative complications in observation group and control group were 15.00% and 22.22%,respectively,there was no statistically significant difference between the two groups(P >0.05).The indexes of postoperative degree in observation group were statistically significantly better than those in control group(P<0.05).In the two groups,the levels of myoelectricity after treatment were significantly improved compared with before treatment(P<0.01),but there was no statistically significant difference between the two groups(P >0.05).At 6 and 12 months after treatment,the scores of PFIQ-7,PFDI-20,and PISQ-12 in observation group were statistically significantly lower than those in control group(P<0.05).At 6 months after treatment,there was no statistically significant difference in the recurrence rates of stress urinary incontinence and pelvic organ prolapse between the two groups(P >0.05).At 12 months after treatment,the recurrence rates of stress urinary incontinence and pelvic organ prolapse in observation group were statistically significantly lower than those in control group(P<0.05).Conclusion The effect of pelvic floor suspension in treatment of PFD is significant,the method can significantly reduce postoperative complications,restore postoperative pelvic muscle strength,reduce long-term recurrence rate,and improve life quality and sexual life quality of the patients.