不同术式治疗重度盆腔脏器脱垂的临床对比研究

目的探讨不同术式治疗重度盆腔脏器脱垂的临床效果,以期提高临床效果。方法选取2009年1月至2012年4月广西壮族自治区民族医院收治的120例重度盆腔脏器脱垂患者为研究对象,依据住院号单双分成两组:对照组(57例)予以阴道子宫全切除术+阴道前、后壁修补术,观察组(63例)予以全盆底重建术,观察两组治疗后的临床效果。结果观察组患者的手术时间、术中出血量、住院天数、术后引流量均显著低于对照组,差异有统计学意义(P<0.05)。两组患者术前盆底困扰量表简表(PFDI-20)、盆腔器官脱垂困扰量表(POPDI-6)、结直肠肛门困扰量表(CRADI-8)、排尿困扰量表(UDI-6)评分比较差异无统计学意义(P>0.05);治疗半年和治疗1年后以上各量表评分均呈下降趋势(P<0.05),且观察组以上各量表评分均较对照组降低更显著(P<0.05)。观察组尿失禁、排尿困难、性交痛的发生率均低于对照组,差异有统计学意义(P<0.05)。结论全盆底重建术治疗重度盆腔脏器脱垂总体临床效果满意,并发症发生率较低。

Clinical Comparative Study of Different Surgical Treatments of Severe Pelvic Organ Prolapse

Objective To investigate the clinical effect of surgical treatment for severe pelvic organ prolapse,in order to improve clinical results. Methods A total of 120 patients with severe pelvic organ prolapse admitted to the Guangxi Zhuang Autonomous Region People＇s Hospital during Jan. 2009 and Apr. 2012 were included in the study,and were randomly divided into two groups based on odd and even number of hospitalization, the control group （ 57 cases） received vaginal hysterectomy ＋ vagina anterior, posterior wall repair while the observation group （63 eases） received total pelvic floor reconstruction, the clinical effect of the two groups was observed. Results The operation time, intraoperative bleeding, hospitalization time, postoperative drainage volume of the observation group were significantly lower than those of the control group （ P 〈 0.05 ）. The two groups bad no statistically significant differences in preoperative PFDI-20, POPDI-6, CRADI-8, UDI-6 score （ P 〉 0.05 ） ; after half a year and 1 year of treatment above scale score were all in a down trend （P 〈 0.05 ）, and scores of all scales of the observation group were decreased more significantly than the control group （ P 〈 0.05 ）. Incontinences of urine, dysuria, dyspareunia of the observation group were lower than the eontrol group, with statistically significant difference （ P 〈 0.05 ）. Conclusion The overall clinical effect of total pelvic floor reconstruction surgery for severe pelvic organ prolapse is satisfactory, with lower incidence of complications.