子宫托治疗女性盆腔器官脱垂的前瞻性研究

Prospective Study of Pessary Treatment for Women with Pelvic Organs Prolapse

目的:探讨子宫托对女性盆腔器官脱垂的治疗效果和失败因素。方法:采用前瞻观察方法对66例子宫托治疗盆腔器官脱垂患者的治疗结局进行放置后1周、1个月和3个月的随诊观察分析。结果:1个月后子宫托佩戴率为72.7%(48/66),子宫托佩戴3个月以上的治疗成功率为65.2%(43/66),两者比较差异无统计学意义(P>0.05)。治疗过程中无严重并发症发生。治疗成功组与治疗失败组患者在盆腔器官脱垂合并隐匿性压力性尿失禁、阴道长度缩短、阴裂增大、既往盆腔重建手术病史以及既往经阴道手术史的比例,两组分别比较差异均无统计学意义(P均>0.05)。治疗失败的主要原因为取放子宫托困难。结论:子宫托是有效治疗盆腔器官脱垂的非手术方法,但并非所有盆腔器官脱垂患者均可采用。

Objective：To probe the effectiveness of pessary treatment for women with pelvic organ prolapse（POP）,and analyze the risk factors of treatment failure.Methods：In this prospective study,we analyzed the results of 66 women with POP 1 week,1 month,and 3 months after implementation of pessary.Results：The successful rates of satisfactory pessary fitting over 1 month and 3 months were 72.7%（4866）and 65.2%（4366）respectively.There was no significant difference between them（P0.05）.No severe complications were observed during the treatment.Compared with successful group,there was no statistic significant difference in failure group concerning pelvic organ prolapse accompanying with occult stress urinary incontinence,shortened vagina,widened vulval slit,previous pelvic reconstruction surgery,and previous pervaginal surgery（all P0.05）.The major cause of treatment failure was difficulty management of the pessary.Conclusions：Pessary is an effective and conservative treatment of POP.However,it is not suitable for every patient with POP.