影响重度盆腔脏器脱垂患者选择外科手术治疗的相关因素

Related factors affecting choice of surgical treatment in patients with severe pelvic organ prolapse

目的探讨影响重度盆腔脏器脱垂(POP)患者选择外科手术或子宫托治疗的相关因素。方法选取新疆维吾尔自治区人民医院于2009年8月至2013年6月期间收治的120例重度POP患者,根据治疗方案分为外科手术治疗组和子宫托治疗组,比较分析两组患者的临床数据,探讨影响重度POP患者选择外科手术或子宫托治疗的相关因素。结果 79例患者(65.83%)选择了外科手术治疗归入外科组,其余41例患者(34.17%)选择了子宫托治疗归入子宫托组。外科组患者的发病年龄、体质量指数均显著高于子宫托组患者(t值分别为2.602、2.161,均P<0.05);子宫托组患者的病程显著长于外科组患者(t=3.769,P<0.05);两组患者中肺部和心脏疾病的发生率以及中盆腔POP-Q分度比较均具有统计学差异(χ~2值分别为4.913、4.753,t=2.432,均P<0.05)。肺部疾病、心脏疾病、中盆腔POP-Q分度以及病程长短均是影响患者选择治疗方案的因素(χ~2值分别为4.142、4.612、6.742、5.768,均P<0.05)。结论临床上大多数重度POP患者均倾向于采用外科手术进行治疗,其中合并有肺部疾病、心脏病以及病程较短或中盆腔脱垂程度较重的患者更为倾向于外科手术治疗。

Objective To investigate the related factors affecting choice of surgical treatment or pessary in patients with severe pelvic organ prolapse（POP）.Methods A total of 120 patients with severe POP admitted in Xinjiang Uygur Autonomous Region People＇s Hospital from August 2009 to June 2013 were selected and divided into surgical group and pessary group.Clinical data of patients in two groups were compared to explore the factors influencing the choice of surgical treatment or pessary in patients with severe POP.Results Seventy-nine patients（65.83%）choosing surgical treatment were included in surgical group and 41 patients（34.17%）choosing pessary were included in pessary group.Age of onset and BMI of patients in surgical group were significantly higher than those in pessary group（t value was 2.602 and 2.161,respectively,both P〈0.05）.Course of disease in pessary group was significantly longer than that in surgical group（t=3.769,P〈0.05）.Differences in incidences of pulmonary and heart diseases and middle compartment POP-Q grading in two groups were statistically significant（χ~2 value was 4.913 and 4.753,respectively,t=2.432,all P〈0.05）.Lung disease,heart disease,pelvic POP-Q grading,and duration of disease were the factors influencing choice of treatment of patients（χ~2 value was 4.142,4.612,6.742 and 5.768,respectively,all P〈0.05）.Conclusion Most patients with severe POP tend to choose surgical treatment.Patients who are complicated with pulmonary disease,heart disease,short duration of disease or middle compartment POP at severe degree are more inclined to surgical treatment.