新式盆底重建术在盆腔器官脱垂患者中的治疗效果及对下尿路功能的影响

The Effect of New Pelvic Floor Reconstruction in Patients with Pelvic Organ Prolapse and Its Influence on the Function of Lower Urinary Tract

目的探讨新式盆底重建术在盆腔器官脱垂患者中的治疗效果及对下尿路功能的影响。方法选取2013年5月至2015年5月德阳市第二人民医院妇产科接诊的盆底器官脱垂的患者70例,按照随机数字表法分为观察组和对照组,各35例。观察组患者使用新式Prolift盆底重建术治疗,对照组采用传统盆底重建术。观察两组患者治疗前后盆腔器官脱垂(POP-Q)分期变化和手术情况及治疗后下尿路功能障碍例数。并进行1年随访,记录盆底功能障碍问卷(PFDI-20)评分。结果治疗后,观察组POP-Q分期情况优于对照组[0期:100%(35/35)比82.86%(29/35),Ⅰ期:0%(0/35)比11.42%(4/35),Ⅱ期:0%(0/35)比5.72%(2/35)],观察组下尿路功能障碍总发生率低于对照组[14.29%(5/35)比71.43%(25/35)],差异有统计学意义(P<0.05);观察组手术时间、术中出血量、术后残余尿量、住院时间均低于对照组[(94±29)min比(125±38)min,(186±53)m L比(235±74)m L,(32±9)m L比(48±12)m L,(7.3±2.1)d比(9.8±2.9)d](P<0.01),通过随访,观察组术后12个月PFDI-20评分显著低于对照组[(15±3)分比(21±3)分],差异有统计学意义(P<0.05)。结论新式Prolift盆底重建术对盆底器官脱垂患者疗效显著,可以良好地改善患者的下尿路的功能,值得在临床上应用推广。

Objective To investigate the effect of the new type of pelvic floor reconstruction in patients with pelvic organ prolapse and the influence on the function of lower urinary tract. Methods Total of 70 cases of pelvic organ prolapse in Deyang Second People＇s Hospital from May 2013 to May 2015 were included in the study,and divided into an observation group and a control group according to the random number table method,35 cases each. The observation group were treated with the new Prolift pelvic floor reconstruction,and the control group was treated with the traditional pelvic floor reconstruction. The changes of POP-Q（ pelvic organ prolapse quantitation） stage and the number of urinary tract dysfunction after treatment and the surgery condition of the two groups were observed. And a year of follow-up was done to obtain the Pelvic Floor Distress Inventory-short form 20（ PFDI-20） score. Results The POP-Q stage of the observation group was better than the control group [period 0： 100%（ 35 /35） vs 82. 86%（ 29 /35）,period Ⅰ： 0%（ 0 /35） vs11. 42%（ 4 /35）,period Ⅱ： 0%（ 0 /35） vs 5. 72%（ 2 /35） ],the total incidence of urinary tract dysfunction in the observation group was lower than that of the control group[14. 29%（ 5 /35） vs 71. 43%（ 25 /35） ]（ P〈0. 05）; the operation time,the intraoperative bleeding voluem,postoperative residual urine volume,hospitalization time of the observation group were lower than the control group[（ 94 ± 29） min vs（ 125 ± 38）min,（ 186 ± 53） m L vs（ 235 ± 74） m L,（ 32 ± 9） m L vs（ 48 ± 12） m L,（ 7. 3 ± 2. 1） d vs（ 9. 8 ± 2. 9） d]（ P〈0. 01）; the PFDI-20 score of the observation group was lower than the control group [（ 15 ± 3） score vs（ 21 ± 3） score]at postoperative twelfth months,with statistically significant difference（ P〈0. 05）. Conclusion The new Prolift pelvic floor reconstruction surgery has a significant effect on the patients with pelvic organ prolapse,which can improve the lower urinary tract function of the patients,thus is worthy to be popularized in clinical.