全盆底重建保留子宫与切除子宫术后盆底功能及生活质量评估的比较

Comparison of the Therapeutic Effectiveness and Impact to Life Quality of Uterus-reserved or Hysterectomized Total Pelvic Floor Reconstruction

目的:探讨全盆底重建保留子宫和切除子宫术后患者盆底功能恢复情况及生活质量的差异。方法:选取两所医院自2007年1月至2011年11月行全盆底重建术患者48例,其中子宫切除22例(CH组),保留子宫26例(UC组)。术前及术后12个月进行盆腔器官脱垂定量(POP-Q)分度和生活质量问卷调查。结果:术前及术后12个月POP-Q值CH组与UC组比较,差异均无统计学意义(P>0.05);两组组内术前与术后的POP-Q分度测量值比较,差异均有统计学意义(P<0.05)。两组术后盆底功能影响评分、盆底功能障碍评分、性生活评分比较,差异无统计学意义(P>0.05)。两组无一例脱垂复发,除1例发生网片排斥暴露,余无其他并发症发生。结论:保留子宫的全盆底重建术损伤小,手术安全。术后12个月患者盆底功能恢复情况以及生活质量,保留子宫与切除子宫的全盆底重建术效果无明显差别。

Objective： To compare the therapeutic effectiveness and impact to life quality of uterus-re- served or hysterectomized total pelvic floor reconstruction. Methods：48 patients underwent total pelvic floor reconstruction in these two hospitals from January 2007 to November 2011, among whom 22 cases were treated with hysterectomized total pelvic floor reconstruction （ group CH）, 26 cases were treated with ute- rus-reserved or hysterectomized total pelvic floor reconstruction （group UC）. Pelvic organ prolapse quantita- tion（POP-Q） and questionnaire of life quality of the patients were done 12 months before and after the oper- ation in the two groups. Results.There was no significant difference in POP-Q score, pelvic floor dysfunction score and sexual life quality between these two groups 12 months before and after the operation between group CH and UC（ P 〉 0.05）. However,there was significant difference in POP-Q score between before and after the operation in both two groups （ P 〈 0. 05）. No other severe complications occurred in all of the pa- tients, except for one case with mesh exposure. Conclusions： Uterus-reserved total pelvic floor reconstruc- tion is little hurt,safe and effective and there is no significant difference in therapeutic effectiveness and im- pact to life quality between uterus-reserved and hysterectomized total pelvic floor reconstruction.