绝经期女性泌尿生殖综合征患者治疗疗效的多系统评价模式初探

Evaluation of clinical characteristics of genitourinary syndrome in postmenopausal women

回顾分析2014年3月至2015年2月因外阴阴道不适、反复泌尿系感染、性交痛就诊的1 10例女性自然绝经后期患者的临床资料.58例用雌三醇软膏治疗（A组）,52例用保妇康栓＋皮肤康洗液治疗（B组）,随访6个月,观察阴道健康评分、泌尿系症状、盆底肌肉松弛度变化,综合生殖泌尿系统、盆底萎缩情况行治疗前后的多系统综合再评估,符合绝经期女性泌尿生殖综合征诊断.A组绝经年龄（49.3±4.0）岁,绝经时间（15.8±5.9）年;B组绝经年龄（50.6±4.8）岁,绝经时间（16.4±6.9）年.治疗6个月后A组阴道健康评分提高,尿道肉阜（78％与7％）、盆腔脱垂（36％与21％）发生率下降.提示绝经期泌尿生殖综合征作为新术语,扩大了既往对绝经后女性雌激素低下造成生殖道萎缩的认识,诊断标准需要结合外阴阴道萎缩改变、尿动力学改变和盆底肌肉松弛度多系统客观评价,才能达到指导临床治疗目的.

One hundred and ten postmenopausal women,complaining vaginal discomfort,recurrent urinary tract infections or painful intercourse and visiting the hospital between March 2014 and February 2015 were enrolled in the study.Among them,58 patients received vaginal administration of estriol estriol ointment （group A） and 52 patients received conventional treatment （group B）.There were no significant differences in mean age of menopause and mean menopause duration between two groups.The clinical symptoms,vaginal health scores,pelvic organ prolapse were observed after treatment.After 6-month treatment,the female vaginal health score was significantly improved in women group A,the rate of urinary orifice was reduced （78％ vs.7％）,and the rate of pelvic organ prolapse was decreased （36％ vs.21％）.The geritourinary syndrome of menopause is a new term for vulvovaginal atrophy with clinical characteristics of multi-system changes in postmenopausal women,including atrophic vaginitis,female urogenital diseases,and pelvic organ prolapse.The new diagnostic criteria are needed for evaluation and management of geritourinary syndrome.