应用全盆底重建术治疗老年女性重度盆腔器官脱垂临床分析

A retrospective study on the total pelvic floor reconstruction surgery for elderly women patients of severe pelvic organ prolapse

目的 评价全盆底重建术治疗老年女性重度盆腔器官脱垂的疗效.方法 回顾性分析34例POP-QⅢ～Ⅳ期盆腔器官脱垂行全盆底重建术的老年患者临床资料,评价该手术疗效及对患者生活质量的影响.结果 所有手术均安全顺利进行,未见膀胱、直肠等损伤;手术时间（105±31.2） min,出血（185.4±65.9） mL;所有患者术后4～5d后均自主排尿.随访2年,复发率为0（0/34）;PFIQ评分由术前的（84.3±22.6）分降至术后2年的（11.2±6.5）分,PFDI评分由术前的（75.8±19.4）分降至术后2年的（12.4±5.3）分.结论 全盆底重建术用于纠正老年女性重度盆腔器官脱垂,手术安全,术后生活质量改善明显,值得临床推广应用.

Objective To evaluate the clinical effects and quality-of-life outcomes of total pelvic floor reconstruction surgery for old patients of severe pelvic organ prolapsed. Methods We retrospectively analyzed the clinical data of 34 old patients with severe pelvic organ prolapsed （stage Ⅲ to Ⅳ according to POP-Q staging）. Results All surgical operations were performed successfully and no injuries of bladder or urethra were found. The mean operation duration was （105±31.2） rain, and the mean intra-operative blood loss was （185.4±65.9） mL. All patients were able to micturate spontaneously 4-Sdaysaftersurgery. Under 2-years follow-up, no recurrence was found and the PFIQ scores dropped from （84.3±22.6） before surgery to （11.2±6.5） two years later after surgery. Simultaneously the PFDI scores decline from （75.8±19.4） before surgery to （12.4±5.3） two years later after surgery. Conclusion Total pelvic floor reconstruction surgery can achieve the recovery of of severe pelvic organ prolapsed for old patients and may be worthy to be further applied in clinics.