阴道半封闭术治疗老年严重盆腔器官脱垂临床分析

Clinical analysis of the effect of the partial colpocleisis on elderly patients with pelvic organ prolapse

目的：评估阴道半封闭术加会阴体重建治疗老年严重盆腔器官脱垂的安全性和有效性。方法对2008年8月至2012年5月解放军总医院妇科收治的老年严重盆腔器官脱垂患者行阴道半封闭术35例，观察术中术后情况、术后随访及生活质量。结果盆腔器官脱垂分度（POP-Q）评估显示Ⅲ期5例，Ⅳ30例。手术麻醉方式：硬膜外25例（71．4％），全麻10例。平均手术时间（52．0±6．4）分钟；平均出血量为（63．0±10．8）mL；术后平均住院时间为（4．0±1．8）天。随访6～48个月，期间无复发，未出现新发尿失禁病例，主观满意率为100％。结论对于无性生活要求、并有严重盆腔器官脱垂的高龄妇女，阴道半封闭术加会阴体重建是一种安全、有效的手术。

Objective To evaluate the safety and effectiveness of partial colpocleisis and perineoplasty on elderly patients with severe pelvic organ prolapse （ POP） .Methods There were 35 elderly patients with severe POP undergoing partial colpocleisis in gynecology department of Chinese PLA General Hospital from August 2008 to May 2012.Their situation before and after surgery , postoperative follow-up and life quality were observed .Results Pelvic organ prolapse quantitation （ POP-Q） evaluation indicated 5 cases of stage III and 30 cases of stage IV.In anesthesia method 25 cases （ 71.4%） accepted epidural anesthesia and 10 cases accepted general anesthesia .The average operation course, average bleeding volume and average postoperative hospitalization stay was 52.0 ±6.4min, 63.0 ±10.8mL and 4.0 ± 1.8 days, respectively.The cases were followed up for 6 to 48 months.No recurrence during the follow-up was found and the subjective satisfactory rate was 100%.No patients were found with urinary problems .Conclusion The partial colpocleisis and perineoplasty is a safe and effective treatment for elderly patients with severe POP but without sexual need .