不同模式的Prolift手术疗效及术后生活质量观察

Observation of efficiency and life quality with three different models of Prolift surgery

目的观察不同模式的Prolift手术疗效及术后生活质量。方法回顾性分析2007年6月至2010年6月武汉大学人民医院收住的盆底脏器脱垂的患者134例。分为3种手术模式:A组Prolift+保留子宫,B组既往有全子宫切除术+Prolift,C组阴式子宫切除+Prolift。分别记录三组患者基本情况、术中术后情况,术后并发症,手术前和术后3、6、12个月盆腔器官脱垂定量(POP-Q)评分及盆底功能障碍影响问卷-短表20(PFIQ-20)进行评估。结果 (1)患者年龄、孕产史、体重及手术前POP-Q评分差异无统计学意义(P>0.05)。(2)C组患者手术时间、出血量较A、B两组患者多,差异有统计学意义(P<0.05)。(3)三组患者手术后并发症比较,差异无统计学意义(P>0.05)。(4)治疗盆腔脏器脱垂的疗效比较,三组患者手术后6个月POP-Q评分复发率A组较C组低,差异有统计学意义(P<0.05);术后1年,A组复发率较B、C两组复发率低,差异有统计学意义(P<0.05),B、C两组复发率比较差异无意义(P>0.05)。(5)三组患者在手术前,术后3个月及术后6个月组间PFDI-20评分比较,差异无统计学意义(P>0.05);术后1年PFDI-20评分比较,A组评分较B、C组高,差异有统计学意义(P<0.05)。结论在三种不同模式的Prolift手术中,保留子宫的Prolift手术时间短、出血量少、复发率低,且远期生活质量及疗效总体评分高于其他手术模式。

Objective To observe the efficiency and life quality with three different models of Prolift surgery.Methods 134 patients who underwent surgery for POP in our department from June 2007 to June 2010 and had following-up information were analyzed retrospectively.The following-up information included general clinical data,pelvic examination,operative and postoperative data,operative complication,PFID-20 questionnaire before and after surgery in three month,six month and twelve month.The patients were divided into three groups：uterus reserved group（group A）,hysterectomy history group（group B）,they were all treated with Prolift operation,and group C were treated with Prolift ＋ vaginal hysterectomy.Results（1）The differences of age,pregnancy history,body weight and POP-Q scoring before operation were not statistically significant between the three groups（P〈0.05）.（2）Group C had more operating time and blood loss than group A and B（P〈0.05）.（3）In surgical complication,there were no significant difference between the three groups（P〈0.05）.（4）As for curative effects of pelvic organ prolapse,the recurrence rate at six month after operation in group A were lower than those of group C（P〈0.05）;the recurrence rate had no significant difference between group B and group C at 1 year after operation（P〈0.05）,but group A were lower than those of group B and group C（P〈0.05）.（5）The PFID-20 score had no significant difference between three groups before operation,three and six month after operation（P〈0.05）,however after 1 year,the PFID-20 score in group A were higher than those of group B and group C（P〈0.05）.Conclusions In three different groups of Prolift surgery,the retention of the uterus Prolift had shorter operative time,less blood loss,lower recurrence rate than others,as for curative effects and long-term life quality,the retention of the uterus prolift were higher than other models.