期刊文献+

盆底重建手术治疗老年女性重度盆腔器官脱垂的临床分析 被引量:4

Clinical analysis of Prolift pelvic reconstructive surgery for advanced pelvic organ prolapse in elderly women
原文传递
导出
摘要 目的探讨盆腔重建Prolift手术治疗老年女性重度盆腔器官脱垂(POP)的疗效、安全性及对盆底功能和性功能的影响。方法采用经阴道盆腔重建Prolift手术治疗老年女性重度POP患者42例,POP—Q法分期均为Ⅲ~Ⅳ期,年龄60~79岁,平均(68±8)岁,观察手术时间、出血量及并发症,分别于术后1、6个月随访手术疗效,并对手术前后的盆底功能障碍问卷简表(PFDI-20)、盆底功能影响问卷简表(PFIQ-7)及性功能调查问卷评分(PISQ_31)进行比较。结果42例患者的手术时间为35~78min,平均(42±25)min,术中出血量50~300ml,平均(137士58)ml,无手术其他损伤、死亡,无术中术后并发症。42例患者术后全部治愈,无复发。患者术后1个月、6个月PFDI20、PFIQ-7分别为(4.5±1.4)分和0分(7.8±4.3)分才0分,较术前(47.9±12.2)分、(76.3±17.9)分降低(P〈0.01);术后1、6个月PISQ-31分别为(49.8±6.3)分、(51.1±6.5)分,与术前(52.3±4.3)分比较,差异无统计学意义(P〉0.05)。结论Prolift手术治疗老年重度POP安全,能改善老年患者的生活质量。 Objective To evaluate the safety and efficacy of Prolift pelvic reconstructive surgery for advanced pelvic organ prolapse in elderly patients, and to investigate its impact on pelvic floor function and sexual function. Methods Totally 42 patients aged 60-79 years with advanced pelvic organ prolapse Pelvic Organ Prolapse Quantification (POP Q) stage UI , n= 30; POP-Q IV, n-12) were selected in this study. All patients underwent total ProlUt procedure, and were followed up at month 1 and 6 after operation. Operation time, bleeding volume and postoperative complications were recorded. The impact of total Prolift procedure on pelvic floor function in patients were assessed by pelvic floor distress inventory short form 20 (PFDI-20), the pelvic floor incontinence questionnaire 7 (PFIQ-7) and the pelvic organ prolapsed and incontinence sexual quality questionnaire 31 (PISQ-31). Results The operative time was (35 78) minutesmean time:(42±25) minutes. Bleeding volume was (50-300) ml mean volume: (1374-58) ml. No bladder injury, rectum injury and postoperative complications were observed. All patients were cured, and no one recurred. The scores of PFDI-20 and PFIQ-7 were decreased in patients after sugery at 1-and 6-month follow-up as compared with before sugery (4.5±1.4, 0 vs. 47.9±12.2; 7.8±4.3, 0 vs. 76.3±17.9, respectively, all P〈 0.01). There were no significant differences in scores of PF1Q-7 between before and after sugery at 1- and 6-months follow up (52.3 4±4.3 vs. 49.8 4-6.3, 51.1 ±6.5, P〈0.05). Conclusions Prolift pelvic reconstructive surgery is an safe and effective treatment for advanced pelvic organ prolapse, which can significantly improve quality of life in elderly patients.
机构地区 北京医院妇产科
出处 《中华老年医学杂志》 CAS CSCD 北大核心 2013年第9期980-982,共3页 Chinese Journal of Geriatrics
关键词 子宫脱垂 妇科外科手术 Uterine prolapse Gynecologic surgical procedures
  • 相关文献

参考文献1

二级参考文献14

  • 1郎景和,朱兰.女性盆腔器官膨出疾病[J].现代妇产科进展,2005,14(2):81-86. 被引量:11
  • 2Harout M, Mark DW, Tommaso F. Laparoscopic management of pelvic organ prolapseJ . Euro J Obstet Gynecol, 1999, 85:57.
  • 3Lin LL, Ho MH, Haessler AL, et al. A review of laparoscopic uterine suspension procedures for uterine preservation. Curr Opin Obstet Gynecol, 2005, 17:541-546.
  • 4Paraiso MF. Surgery for apical vaginal prolapse. Curr Womens Health Rep, 2002,2:285-290.
  • 5Karram M, Goldwasser S, Kleeman S, et al. High uterosacral vaginal vault suspension with fascial reconstruction for vaginal repair of enterocele and vaginal vault prolapse. Am J Obstet Gynecol, 2001,185:1339-1342.
  • 6Hewson AD. Transvaginal sacrospinous colpopexy for posthystereetomy vault prolapse. Obstet Gynecol,1998,38:318-324.
  • 7Carey MP, Slack MC. Transvaginal sacrospinous colpopexy for vault and marked uterovaginal prolapse.Brit J Obstet Gynecol, 1994,101 : 536-540.
  • 8Hoffman MS, Harris MS, Bouis PJ. Sacrospinous colpopexy in the management of uterovaginal prolapse.J Reprod Med, 1996,41:299-303.
  • 9Colombo M, Milani R. Sacrospinous ligament fixation and modified McCall culdoplasty during vaginal hysterectomy for advanced uterovaginal prolapse. Am J Obstet Gynecol, 1998,179 : 13-20.
  • 10Hardiman PJ,Drutz HP. Sacroopinous vault suspension and abdominal colposacropexy, success rates and complications. Am J Obstet Gynecol, 1996, 175:612-616.

共引文献1

同被引文献47

  • 1丰有吉.妇产科学[M].第2版.北京:人民卫生出版社,2010:68-69.
  • 2Kerkhof MH, Hendriks L, Brolmann HAM. Changes ineonnective tissue in patients with pelvic organ prolapse -a review of the current literature [J]. Int Urogynecol, 2009, 20 : 461-474.
  • 3Subak LL, Waetjen LE, vun den geden S, et al. Cost of pelvic organ prolapse surgery in the United States[J]. Obstet Gynecol, 2001,98 : 646-651.
  • 4Weber AM, Walters MD, Piedmome MR, et al. Antereior colporrhaphy: a randomized trial of three surgical techniques[J]. Am J Obstet Gynecol, 2001, 185:1299-1306.
  • 5Sand PK, Kodufi S, Lobei RW, et al. Propective randomized trial of polyglactin 910 mesh to prevent of cystoceles and rectoceles[J]. Am J Obstet Gynecol, 2001,184 : 1357-1362.
  • 6Viana R, Colaco J, Vieira A, et al. Cystocele-vaginal approach to repairing paravaginal fascial defects[J]. Int Urogyneeol J Pelvic Floor Dysfunet, 2006, 17: 621-623.
  • 7MaherC, Baessler K. Surgical management of anterior vaginal wall prolapsed: an evidence based literature review[J]. Int Urogynecol J Pelvic Floor Dysfunct, 2006,17 : 195-201.
  • 8Young SB, Dman J J, Bony LG. Vaginal paravaginal repair: one-year outcomes[J]. Am J Obstet Gynecol, 2001, 185:1360-1366.
  • 9Clemons JL, Myers DL, Aguilar VC, et al. Vaginal paravaginal repair with an AlloDerm graft [J]. Am J Obstet Gynecol,2003,189:1612-1619.
  • 10Chaudhry AR, Lobel RW. Posterior colporrhaphy with alloderm graft augmentation: natomical and functional out-comes [J]. J Pelvic Surg, 2005,11: 67- 68.

引证文献4

二级引证文献18

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部