Prolift全盆底重建术治疗盆腔脏器脱垂的临床研究

Clinical study on pelvic organ prolapse treated with Prolift pelvic floor reconstructive surgery

目的评价Prolift盆底重建术对盆腔器官脱垂(pelvic organ prolapse,POP)的临床治疗效果和应用价值。方法对27例患者根据其不同情况及类型选择手术方式:单纯的全盆底修复盆底重建术20例,全盆底修复盆底重建术+阴式全子宫切除术4例,全盆底修复盆底重建术+尿道肉阜切除术1例,曾经次全子宫切除病史患者本次行宫颈切除+尿道折叠术+全盆底修复盆底重建术1例,尿道折叠术+全盆底修复盆底重建术1例。结果 27例患者均顺利完成手术。术中出血量50～200 mL,平均为(96.67±47.96)mL;手术时间65～149 min,平均为(96.44±27.49)min。27例患者术后恢复好,术后最高体温36.9℃～39.0℃,平均(37.87±0.52)℃;尿管留置时间3～14 d,平均(5.52±1.85)d,1例术后出现尿潴留。术后患者住院天数5～9 d,平均为(6.48士1.01)d。26例患者术后妇科检查POP-Q分期各位点均在正常范围,未见脱垂复发,1例患者术后11月出现宫颈过长约9 cm。1例患者术后出现性交痛、下腹坠胀。结论 Prolift盆底重建术是治疗盆腔脏器脱垂较好的选择。

Objective To evaluate the treatment outcome of Prolift pelvic floor reconstructive surgery and its value to clinical practice. Methods Different surgical modalities were chosen for patients according to their specific situations ： surgery of pelvic floor repair and reconstruction for 20 patients; surgery of pelvic floor repair and reconstruction plus transvaginal hysterectomy for 4 patients; surgery of pelvic floor repair and reconstruction plus urethral caruncle resection for 1 patient; surgery of pelvic floor repair and reconstruction plus trachelectomy and plication of urethra for 1 patient; and surgery of pelvic floor repair and reconstruction plus plication of urethra for 1 patient. Results Intraoperative blood loss was 50 - 200 ml,with average loss of 96.67 ± 47.96 ml. Operation duration was 65 - 149 minutes, with average duration of 96.44 ± 27.49 minutes. All patients had complete recovery after surgery. The highest temperature was 36.9 - 39.0 ℃, with average temperature of 37.87 ± 0.52 ℃. Indwelling time of urethral catheter was 3 - 14 days, with average time of 5.52 ± 1.85 days. One patient experienced urinary retention. Postoperative in-hospital time was 5 - 9 days, with average time of 6.48 ± 1.01 days. Twenty-six patients had normal POP-Q values, and no recurrent prolapsed was found. One patient had elongation of cervix. One patient experienced algopareunia and abdominal bulge. Conclusions Prolift pelvic floor reconstructive surgery is a good option for patients with pelvic organ prolapse.