女性盆底功能障碍性疾病改良术式的临床研究

Clinical study on the improved surgical technique of female pelvic floor dysfunction

目的:探讨女性盆底功能障碍性疾病改良术式即曼氏术及阴道旁修补联合中央阴道自体组织"桥"式修补术的临床应用价值。方法:总结分析采用改良术式治疗子宫脱垂合并阴道前(后)壁膨出的20例患者(观察组),并与同期行传统的阴式全子宫切除及阴道前壁修补术的病例(对照组)进行比较。结果:观察组20例均取得满意效果,手术时间观察组65～125 min,对照组55～120min。出血量观察组50～200 mL,平均119.34 mL,对照组55～180 mL,平均105.25 mL,差异有显著性(P=0.005)。两组均无排尿困难及尿潴留,术后随访3～12个月,观察组术后1个月复查阴道深度(前壁长度)5～9 cm,平均6.96 cm,对照组阴道深度3～6cm,平均5.55cm,差异有显著性(P=0.00)。术后随访观察组无复发,主观满意度100%,客观满意度95%。对照组2例分别于术后6、11个月复发阴道前壁膨出Ⅰ度,复发率11%,主观满意度94%,客观满意度90%。与病例组相比差异有显著性(P=0.036)。结论:改良术式阴道旁修补联合阴道前/后壁中央自体组织"桥"式修补术,并可联合盆腔其他手术如曼氏术,能有效治疗女性盆底功能障碍性疾病。

Objective：To evaluate the the clinical value of improved surgical technique, Man＇s Joint Central vaginal vagi2 nal paravaginal repair with autologous tissue ＂bridge＂ type repair, in treating female pelvic floor dysfunction. Methods： To analyze 20 patients （observation group） using modified surgical treatment of uterine prolapse vaginal ago （rear） wall bulging in Ganzhou People＇s Hospital from June 2006 to June 2009, and compare with the cases in the same period with the traditional vaginal OK vaginal hysterectomy and anterior repair （control group）. Results ：The group of 20 patients have achieved satisfactory results, surgical time ha the observat/on group was 65-125 min, control group 55-120 min. The amount of bleeding in the observation group 50-200mL, an average of 119.34 mL; control group, 55-180 mL, an average of 105.25 mL, the difference was significant （P=-0.005）. There were no voiding difficulties and urinary retention, postoperative follow-up 3 to 12 months in the observation group after 1 month review of vaginal depth （anterior length） 5-9 cm, an average of 6.96 cm; control group, the depth of the vagina 3 -6 cm, an average of 5.55 cm, the difference was significant （P=-0.00）. There were no recurrence after follow-up study, subjective satisfaction was 100%, the objective satisfaction was 95%.2 patients in the control group, respectively, 6,11 months after operation, with anterior vaginal prolapse recurrence of grade Ⅰ , the recurrence rate of 11%, 94% of subjective satisfaction and 90% of objective satisfaction. Difference compared with the case group was significantly （P=- 0.036）. Conclusion ：The modified surgical vaginal paravaginal repair the joint vagina before / posterior wall of the central autologous tissue ＂bridge＂ type of repair,combined with other operations, such as Man＇s pelvic surgery, can be effective for female pelvic floor dysfunction.