聚丙烯合成网片和生物补片在前盆底重建术中的临床价值

Clinical value of sythetic polypropylene mesh and biological patch in anterior pelvic floor reconstruction

目的对比分析聚丙烯合成网片和生物补片在前盆底重建术中的应用效果。方法选取2013年11月至2015年1月重庆江津区第二人民医院妇科手术治疗的147例盆底功能障碍疾病患者进行回顾性分析,其中82例患者选择聚丙烯合成网片(聚丙烯组),65例患者选择生物补片(生物组),对比两种补片的临床效果。结果生物组患者的手术时间、手术出血量均显著高于聚丙烯组患者,差异具有统计学意义(t值分别为17.622、29.851,均P<0.05);两组患者的手术后最高体温值、尿管留置时间、残余尿液量差异不具有统计学意义(t值分别为0.409、1.302、1.033,均P>0.05)。术后3个月,生物组患者的PFIQ-7、PFIQ-20评分均显著低于聚丙烯组患者,差异具有统计学意义(t值分别为6.109、5.827,均P<0.05)。术后6个月,生物组患者的Aa、Ba、Ap、Bp、C测定值均显著低于聚丙烯组患者,差异具有统计学意义(t值分别为2.298、3.126、4.085、3.301、2.904,均P<0.05)。生物组患者的手术并发症率4.62%显著低于聚丙烯组患者的15.85%,差异具有统计学意义(χ~2=4.721,P<0.05)。结论生物补片在前盆底重建术中手术时间较长、出血量较大,但是具有术后效果更好,并发症更少的优点。

Objective To compare and analyze the application effect of synthetic polypropylene mesh and biological patch in anterior pelvic floor reconstruction. Methods Altogether 147 cases of pelvic floor dysfunction（ PFD） receiving surgical treatment in gynecology department in Second People＇s Hospital of Jiangjin District in Chongqing from November 2013 to January 2015 were retrospectively analyzed. Among them 82 patients were implanted with synthetic polypropylene mesh（ polypropylene group） and 65 patients with biological patch（ biological group）. Clinical effect of two kinds of patches was compared. Results Operation time and amount of bleeding of patients in biological group were significantly higher than those in polypropylene group,and the differences were statistically significant（ t value was 17. 622 and29. 851,respectively, both P〈0. 05）. There was no significant difference between two groups in postoperative maximum body temperature,indwelling time of catheter and residual urine volume（ t value was 0. 409,1. 302 and 1. 033,respectively,all P〉0. 05）.Three months after operation, PFIQ-7 and PFIQ-20 scores of patients in biological group were significantly lower than those in polypropylene group,and the differences were statistically significant（ t value was 6. 109 and 5. 827,respectively,both P〈0. 05）. Six months after surgery,Aa,Ba,Ap,Bp and C values of patients in biological group were significantly lower than those in polypropylene group with significant differences（ t value was 2. 298,3. 126,4. 085,3. 301 and 2. 904,respectively,all P〈0. 05）. Postoperative complications rate of 4. 62% in biological group was lower than 15. 85% in polypropylene group,and the difference was statistically significant（ χ^2= 4. 721,P〈0. 05）. Conclusion Anterior pelvic floor reconstruction surgery with biological patch has longer operation time and larger amount of bleeding,but has the advantages of better postoperative results and fewer complications.