Prolift全盆悬吊术与经阴道子宫切除+阴道前后壁修补术在盆腔脏器脱垂治疗的对比研究

A comparative study of the treatment in pelvic organ prolapse by prolift basin wide suspension surgery and vaginal hysterectomy + anterior and posterior wall repair

目的:探讨Prolift全盆悬吊术与经阴道子宫切除(TVH)+阴道前后壁修补术在盆腔脏器脱垂中的治疗作用并进行对比。方法:选择盆底脏器脱垂(POP)患者共45例,25例行Prolift全盆悬吊术设为Prolift组,20例行TVH+阴道前后壁修补术设为TVH组,比较两组手术结果并随访两组的疗效。结果:Prolift组在手术时间、术中出血、术后住院天数显著低于TVH组(P均<0.05),两组在持续导尿时间和并发症发生差异无统计学意义(P>0.05),两组患者出院前行POP-Q评测均已达到治愈标准。两组随访12个月后发现Prolift组2例复发,治愈率92.0%,复发率8.0%;TVH组4例复发,治愈率80.0%,复发率20.0%,两组复发率差异无统计学意义(P>0.05)。结论:Prolift全盆悬吊术能重建盆底结构,借助网片恢复盆底的正常解剖,改善盆底功能,手术安全性高,术后复发率较低,其疗效优于TVH+阴道前后壁修补术。

Objective： To explore the treatment and contrast of pelvic organ prolapse by prolift basin - wide suspension surgery and vaginal hysterectomy ＋ anterior and posterior wall repair. Methods： A total of 45 eases of pelvic floor organ prolapse （POP） patients were collected. 25 cases were taken prolift basin - wide suspension surgery, which combined into prolift group. 20 cases were taken TVH ＋ vagi-nal anterior and posterior wall repair, which comprised the TVH group. Surgical outcomes and follow - up of the efficacy of two groups were compared. Results： Operation time, blood loss, postoperative hospital stay in prolift group were significantly lower than those of TVH group （ P 〈 0. 05 ） . There were no significant differences in the time continuous catheterization and complications between two groups. Patients of the two groups all had reached the standard cure before discharge by POP - Q evaluation. In prolift group, 2 patients relapsed after 12 months by follow - up. The cure rate was 92.0% and the recurrence rate of 8.0%. While 4 patients in TVH group had relapsed with the cure rate 80. 0% and the recurrence rate 20. 0%. The relapse rate between two groups was no statistically different （ t = 1. 384, P = 0. 239） . Conclusion-Prolift basin - wide sling procedure can reconstruct the pelvic floor structure, restore the normal anatomy of the pel-vic floor with the mesh. The pelvic floor function, surgery safe, low recurrence rate and its efficacy are superior to TVH ＋ vaginal anterior and posterior wall repair surgery.