经阴道全盆底网片悬吊术的临床效果分析

Transvaginal pelvic mesh sling-wide clinical effectiveness analysis

目的 探讨聚丙烯网片在全盆底重建术（保留子宫）治疗盆腔器官脱垂的效果及并发症.方法 对15例盆腔多个部位缺陷的盆腔器官脱垂患者使用聚丙烯网片行保留子宫的全盆底网片悬吊术.14例患者存在3个部位的缺陷,1例患者存在2个部位的缺陷.结果 所有病例穿刺顺利,无膀胱或直肠损伤.手术时间60～150min,平均（85.0±4.3）min,术中出血量150～400ml,平均（200.0±10.1）ml.15例患者术后恢复好,无感染发生.住院时间5～9 d,平均（6.0±0.7）d.术后随访1～12个月,患者盆底结构基本正常,相关症状消失或明显改善.1例患者术后5周复查时发现有网片侵蚀,经过修剪侵蚀的网片后半年随诊恢复正常.结论 经阴道全盆底网片悬吊术是一种能治疗多区域、复杂型盆腔器官脱垂的微创手术σ.在保留子宫的同时能完成全盆底结构和功能的全部或部分重建.短期疗效稳定,长期疗效有待于进一步观察.

Objective To discuss the clinical efficacy and complication of using polypropylene net in pelvic floor reconstruction to treat pelvic floor organ prolapsus. Method From October 2007 to May 2008,15 cases of organ prolapsus of many region defect in pelvic cavity were operated pelvic floor reconstruction, 14 cases had three regional defects,and 1 case had two regional defects. Results All the cases were punctured smoothly without hematoma and injury of blood vessel and organs. The time of operation for 15 cases ranged from 60 to 150 minutes,averaged （85.0±4.3） minutes. The amount of bleeding in operations ranged from 150 to 400 ml,averaged （200.0±0.1） ml. Fifteen cases recovered well after operation without infection.The days in hospital were 5-9 days,averaged （6.0±0.7） days. Following up 1-12 months,pelvic floor structure of all patients were normal,and interrelated symptom disappeared or improved. One case was discovered the net was eroded after 5 weeks. Conclusions Pelvic floor suspension by vagina is a micro operation to treat complicated pelvic floor organ prolapsus. It can accomplish pelvic floor reconstruction and reserve uterus simultaneously, healing efficacy is stable in short-term,but need further observation.