聚丙烯补片在全盆腔重建术治疗盆腔器官脱垂中的效果观察

Effects of polypropylene patch on total reconstructive pelvic surgery for pelvic organ prolapse

目的:探讨不同聚丙烯补片在全盆腔重建术治疗效果及临床价值,以期能为临床上盆腔器官脱垂提供参考。方法:将该院诊治的42例存在多部位盆腔脏器缺陷的脏器脱垂患者随机分组,21例患者使用Gynemesh聚丙烯补片(Gynemesh聚丙烯补片组)、21例患者使用Gynecare Prolift System盆底修复网片系统(Gynecare Prolift System组)行全盆腔重建术,比较两组治疗效果。结果:①两组患者在孕次、产次、绝经年龄等方面比较无统计学意义(P>0.05),年龄比较Gynemesh组比GynecareProlift System组年龄大,两组比较差异具有统计学意义(P<0.05)。术前两组患者POP-Q量化分期比较,阴道前壁的测量点(Aa、Ba)Gynecare Prolift System组重于Gynemesh聚丙烯组,两组比较存在统计学意义(P<0.05),阴道后壁测量点及子宫脱垂程度两组比较无统计学意义(P>0.05)。②两组在手术时间、术中出血量、住院费用方面比较差异存在统计学意义(P<0.05),在术后最高体温、术后残余尿、住院时间方面比较两组差异无统计学意义(P>0.05)。③Gynecare Prolift System组随访率90.48%,随访时间平均(9.42±4.28)个月,1例发生补片侵蚀,Gynemesh聚丙烯组随访率95.24%,随访时间平均(9.28±5.14)个月,3例发生补片侵蚀,两组术后POP-Q分期均恢复正常范围。结论:Gynemesh聚丙烯补片与Gynecare Prolift Sys-tem补片用于全盆腔重建,从治疗效果看两组疗效相当,Gynemesh聚丙烯补片价格相对便宜,更适合于推广,但补片容易出现侵蚀情况,临床使用过程中需要加以关注。

Objective： To explore the effects and clinical value of different polypropylene patches on all pelvic revascularization treatment, hoping to help clinical treatment for pelvic organ prolapse. Methods： 42 cases of organ prolapse patients （ with multiple - site pel- vic viscera defect） were selected and divided randomly into two groups, 21 cases of patients using Gynemesh polypropylene patch （Gyne= meshe polypropylene patch group）, 21 cases of patients using Gynecare Prolift System pelvic floor repair piece System （ Gynecare Prolift Sys- tem group）. The whole pelvic revascularization was done, the therapeutic effects of the two groups were compared. Results：①The compar ison of the two groups was not statistically significant in terms of pregnancy times, labor times and menopause age （ P 〉 0. 05 ） . The age of Gynemesh group was older than that of the Gynecare Prolift System group, the difference of the two groups was statistically significant （ P 〈 0. 05 ）. The comparison of POP - Q classification of the two preoperative groups showed that the measuring point （Aa, Ba） on anterior vagi- nal wall of Gynecare Prolift System group was better than that of Gynemesh polypropylene group （ P 〈 0. 05 ）. The differences in the measur- ing point on posterior vaginal wall and uterine prolapse degree of the two groups were not significant （ P 〉 0. 05 ） . ② The diffences between the two groups were statistically significant in terms of operation time, blood loss and hospital costs （ P 〈 0. 05 ）, while the differences in the highest temperature after operation, postoperative residual urine, hospital stay were not significant （ P 〉 0. 05 ） .③The follow - up rate of Gynecare Prolift System group was 90. 48% and the average follow -up period was （9.42 ± 4. 28 ） months, 1 case being of patch erosion. The follow - up rate of Gynemesh polypropylene patch group was 95.24% and the average follow - up time was （91 28 ± 5. 14） months, 3 ca- ses of patch erosion occuring. The POP - Q classifications in two groups after operation resumed normal range. Conclusion： For the total pelvic reconstruction, Gynemesh polypropylene patch and Gynecare Prolift System patch are of the same efficacy. Gynemesh polypropylene patch is relatively cheaper, more suitable for popularization. But it is prone to erosion, its clinical use therefore needs being paid more attention.