硅胶子宫托保守治疗对盆腔脏器脱垂患者症状和生活质量的影响

Effects of Silicone Pessary Treatment on the Symptoms and Life Quality of Pelvic Organ Prolapse Patients

目的探讨硅胶子宫托保守治疗对盆腔脏器脱垂患者症状和生活质量影响的临床疗效。方法对在我院门诊选择硅胶子宫托进行保守治疗的有症状的盆腔脏器脱垂患者进行随访,同时填写生活质量调查问卷（PFDI-20短表）。采用配对资料的秩和检验进行统计分析。结果2005年11月至2009年3月33例ⅢⅣ期有症状的盆腔脏器脱垂患者在我院门诊选择硅胶子宫托进行保守治疗。其中盆底重建手术术后复发2例,子宫切除术后脱垂2例。31例完成随访（10例来院随访,21例电话随访）,随访率为93.94%,其中23例（74.19%）持续使用。持续使用子宫托患者随访时间为317个月,平均随访时间为（10.04±2.57）个月。27例（81.82%）完成生活质量调查问卷,包括5例放弃治疗患者。PFDI-20总评分POPDI-6（盆腔脏器脱垂）评分、CARDI-8（肠道脱垂）评分和UDI-6（排尿相关症状）上托前评分分别为（54.16±36.12）,（27.78±17.30）,（0.61±1.01）和（25.77±24.10）分,上托后分别下降为（20.20±25.98）,（4.48±5.88）,（0.45±0.84）和（15.28±21.53）分。除CARDI-8评分无明显变化外,其他生活质量量表评分上托前后均具有显著性差异（P〈0.05）。结论硅胶子宫托可以明显缓解盆腔脏器脱垂患者脱垂和排尿相关症状,显著改善患者的生活质量。对于盆腔脏器脱垂患者是一种可供选择的、有效的保守治疗方法。

Objective To evaluate the effects of silicone pessary treatment on relieving the symptoms and improving the life quality of the pelvic organ prolapse patients. Methods From November 2005 to March 2009,33 pelvic organ prolapse （POP-Q stage ⅢⅣ）patients received silicone pessary concervative treatment were followed up and required to complete the Pelvic Floor Distress Inventory-20（PFDI-20） before and after initiating pessary treatment. Results 31 of 33（93.94%）patients finished the follow-up completely. 23 of 31（74.19%）pa- tients continually used the pessary. The follow up time was 3 to 17 （10.04±2.57）months. 27 patients completed the PFDI -20 questionnaires. Before silicone pessary treatment,PFDI20 total score,POPDI6 （Pelvic organ prolapse distress inventory）,CARDI8（ colorectal anal distress inventory 8）and UDI6 （urinary distress inventory 6）scores were （54.16±36.12）,（27.78±17.30）,（0.61±1.01）and （25.77± 24.10）,respectively. After the treatment of pessary,the scores decreased to （20.20±25.98）,（4.48±5.88）,（0.45±0.84） and （15.28± 21.53）,respectively. Except for CARDI8,the PFDI scores decreased significantly after the pessary treatment（P 〈 0.05）. Conclusion Silicone pessary is a viable noninvasive treatment for pelvic organ prolapse. It could relieve the symptoms and improve the life quality of protrusion and voiding dysfunction patients.