子宫托治疗盆腔器官脱垂临床疗效及对患者生活质量的影响

A prospective study of pessary treatment for pelvic organ prolapse and health-related quality-of-life

目的 评价子宫托治疗盆腔器官脱垂（POP）前瞻性临床疗效对患者生活质量的影响.方法 2010年10月至2012年9月,对79例符合纳入标准的症状性盆腔器官脱垂Ⅱ以上患者进行子宫托治疗前瞻性研究,在治疗后3、6个月评价治疗效果、不良反应,并使用验证后健康调查12条简表（SF-12）及盆底障碍影响问卷简版（PFIQ-7）评价患者生活质量.结果 共有79例符合纳入标准的POP患者参加本研究,平均年龄（66±9）岁,平均产次（2.4±1.1）次,病程（68±14）个月,子宫托治疗3及6个月的成功率分别为79.7％ （63/79）和58.2％ （46/63）;患者退出治疗的主要原因为子宫托大小不合适,其次为阴道不适感、尿潴留等;治疗后3个月SF-12总分较治疗前明显提高、PFIQ-7总分较治疗前明显降低（P＜0.05）,随着治疗时间延长SF-12总分有升高趋势（P＜0.05）;PFIQ-7总分治疗后3及6个月比较差异无统计学意义（P＞0.05）,但使用子宫托治疗前后患者PFIQ-7总分差异有统计学意义（P＜0.05）,随着治疗时间延长,患者PFIQ-7总分有降低趋势.结论 子宫托治疗是盆腔器官脱垂的有效非手术治疗,该治疗6个月成功率为58.2％,可明显改善患者的生活质量.

Objective To explore the effects of pessary use on symptomatic improvement and quality-of-life （QOL） in women with pelvic organ prolapse （POP）.Methods For this prospective cohort study,79 patients with symptomatic POP were evaluated for pessary insertion between October 2011 and February 2013.After 3 and 6 months of consistent pessary use,quality of life was assessed with the Chinese version of Short-Form 12-hem Health Survey （SF-12） and pelvic floor impact questionnaire short form （PFIQ-7）.Results Their average age was （66 ± 9） years,average parity （2.4 ± 1.1） and average duration of POP （68 ± 14） months.Among them,63 （79.7%） continued pessary use at 3 months and 46 （58.2%） at 6 months.The reasons for dropout were inappropriate size,discomfort and urinary retention.Compared with baseline findings,SF-12 and PFIQ-7 demonstrated significant improvement in patient QOL at 3 months and 6 months.Conclusion Pessary use results in significant changes of QOL for POP patients.And it is a viable noninvasive treatment for pelvic organ prolapse.