摘要
目的比较应用补片的全盆底重建术与传统阴式全子宫切除及阴道前后壁修补在老年性盆底功能障碍患者治疗中的疗效差异。方法随机选取我院2007年9月至2009年2月间的92例老年盆底功能障碍患者,70例(全盆底重建组)采用补片的全盆底重建术,其中合并压力性尿失禁12例,4例同时行经闭孔阴道无张力尿道中段悬吊带手术(TVT-O);22例(对照组)应用传统阴式全子宫切除及阴道前后壁修补,合并压力性尿失禁3例。结果术后3～18个月门诊复查,全盆底重建组未见术后复发,盆腔器官脱垂(POP)评分法测定均为0度,治愈率达100%;对照组术后复发7例,复发病例均为阴道前壁膨出,其中5例术后POP评分Ⅱ度,2例POP评分Ⅲ度,即阴道穹隆完全膨出,治愈率68%;对于同时合并压力性尿失禁患者,盆底重建组中,通过应用TVT-O或前路补片提升的办法,尿失禁均治愈,对照组中患者症状无明显改善,2例症状加重。结论应用替代材料的全盆底重建术在治疗老年盆底功能障碍中疗效确切。
Objective To compare the efficacy of total pelvic floor reconstruction with mesh patch and vaginal hysterectomy with anterior and posterior vaginal wall repair for presby-pelvic floor dysfunction patients. Methods We randomly chose 92 pelvic floor dysfunction inpatients of our hospital from September 2007 to February 2009 and divided them into 2 groups ： total pelvic floor reconstruction group （n=70） underwent total pelvic floor reconstruction with mesh patch[ 12 patients of this group complicated with stress incontinence,4 patients received tension free vaginal tape-obturator （TVT-O） simultaneously ];control group （n=22） received vaginal hysterectomy with anterior and posterior vaginal wall repair （3 patients of this group complicated with stress incontinence）. A follow-up for 3 to 18 months after the surgery were tak- en in all the patients. Results In total pelvic floor reconstruction group, no recidivate case was found and the POP scores and cure rate were 0 and 100% respectively. In control gt^up,there were 7 recidivate cases,all of who were primary vagina anterior wall bulge patients. The cure rate of control group was 68% ; For the patients complicated with stress incontinence, they were all cured by TVT-O or by ascending the front patch in total pelvic floor reconstruction group, but 1 case was as before operation and 2 cases were even worse in control group. Conclusion Total pelvic floor reconstruction with vicarious materials had a definite efficacy for presby-pelvic floor dysfunction.
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2010年第2期150-152,共3页
Journal of China Medical University
关键词
盆底功能障碍
补片
全盆底重建术
pelvic floor dysfunction
mesh patch
total pelvic floor reconstruction
