Prolift盆底重建术与传统手术治疗盆腔器官脱垂的疗效比较

目的比较Prolift盆底重建术与传统手术的疗效和并发症。方法选取2011年8月至2012年9月郑州大学第i附属医院收治的Ⅲ～Ⅳ度子宫脱垂患者65例，其中35例行聚丙烯网片全盆底重建术（研究组），30例行传统阴式子宫全切＋阴道前后壁修补术（对照组），分析两组患者的手术时间、术中出血量、残余尿量、术后住院时间及并发症情况。结果研究组手术时间、术中出血量、残余尿量、术后住院时间分别是（68．48±15．65）min、（127．60±30．21）ml和（37．25±23．40）ml和（6．11±1．62）d，对照组分别是（93．83±15．12）min、（150．40±35．81）ml、（52．33±36．30）ml和（7．23±1．43）d，两组比较，差异均有统计学意义（P〈0．05）；研究组患者术后阴道总长度（9．75±1．52）cm]与对照组（6．40±1．61）cm]比较，差异有统计学意义（P〈0．05），两组C点值比较，差异有统计学意义（P〈0．05）。术后随访时间4～12个月，研究组2例（5．71%，2／35）阴道后壁网片暴露；对照组3例（10．71％，3／28）术后复发。结论与传统手术相比，应用网片的盆底重建术具有创伤小、出血少、恢复快和疗效好等优势，但存在网片暴露等远期并发症，需要进一步研究。

Comparision of the effect of Prolift pelvic reconstructive approach and traditional surgery for the treatment of pelvic organ prolapse

Objective To compare the curative effect and complications of traditional surgery and Prolift pelvic reconstructive approach lot the treatment of pelvic organ prolapse. Methods Data of 65 patients with pelvic organ prolapse （POP-Q stage of III degree） who underwent surgery in the Third Affiliated Hospital of Zhengzhou University from August 2011 to September 2012 were retrospective analyzed. Among them 35 received Prolift system （research group） and 30 underwent routine traditional surgery （control group）. The operation time, blood loss, re- sidual urine volume, length of hospital stay of two groups were compared. Results The operation time, blood loss, residual urine volume, postoperative hospital stay were （68.48± 15.65） min , （127.60 ± 30.21） ml, （37.25 ± 23.40） ml, （6.11 ±1. 62） d in the research group and were （93.83±15.12） min, （150. 40 ±35.81） ml, （52. 33±36. 30）ml and （7.23 ± 1.43） d in the control group, the differences had statistical significance （P〈0. 05）; The postoperative vaginal total length （TVI.） was （9.75± 1.52） cm in research group which was significant longer than that in control group （6. 40±1.61） cm （P〈0.05）. C point measurement value comparison, similar between the two groups have statistical significance （P〈0.05）. The rest of the POP - Q indexing instructions point had no significant difference between the two groups （P〉0.05）. After 4- 12 months follow-up , there were 2 cases （5.71%, 2/35） of mesh exposure in the research group; 3 cases of recurrence occurred in control group （ 10.71%, 3/28） . Conclusion Compared with the traditional surgery, pelvic reconstructive with mesh kit has the advantages of small trauma, less bleeding, faster recovery and better curative effect but the long- term complications, such as mesh exposure need further follow- up study.