改良阴式子宫切除术治疗老年妇女子宫脱垂的疗效分析

Efficacy of Modified Vaginal Hysterectomy in the Treatment of Uterine Prolapse in Elderly Women

目的探讨改良阴式子宫切除术治疗老年妇女子宫脱垂的疗效。方法 2010-01/2016-12收集河南省正阳县人民医院老年妇女子宫脱垂的患者,患者均符合子宫脱垂诊断标准,为Ⅰ度和Ⅱ度,共38例,根据平行、单盲、随机对照的原则分为实验组与对照组,分别给予改良阴式子宫切除术及传统阴式子宫切除术。比较实验组和对照组治疗前后盆底障碍评分、两组手术指标和两组术后并发症。结果两组患者治疗前后盆底障碍影响简易问卷7评分与盆底功能障碍问卷评分差值相比,实验组均高于对照组(P<0.05);两组患者手术时间与术中出血量对比,实验组均低于对照组(P<0.05);实验组并发症发生率为15.78%,对照组并发症发生率为31.57,其差异无统计学意义(P>0.05)。结论与传统阴式子宫切除术相比,改良阴式子宫切除术治疗老年妇女子宫脱垂疗效肯定,术后患者盆底障碍改善更好,生活质量更高。

Objective To investigate the effect of modified vaginal hysterectomy in the treatment of uterine prolapse in elderly women. Methods The elderly women with uterine prolapse in Zhengyang County People＇s Hospital of Henan Province from January 2010 to December 2016 were selected, a total of 38 cases. The criteria for the diagnosis of uterine prolapse were Ⅰ degrees and Ⅱ degrees. Patients were divided into experimental group and control group according to the principle of parallel, single blind and random control, and were given modified vaginal hysterectomy and traditional vaginal hysterectomy treatments respectively. The pelvic floor disorder scores before and after treatment, the surgical indexes, and the postoperative complications of the two groups were compared. Results Compared the difference of pelvic floor impact questionnaire 7 score and pelvic floor dysfunction questionnaire score in the two groups of patients before and after treatment, the experimental group was higher than the control group （ P 〈 0. 05 ）. Comparison of operation time and intraoperative bleeding in two groups of patients, the experimental group was lower than the control group （P 〈0. 05）. The incidence of complications in the experimental group was 15. 78%, while that in the control group was 31. 57%, the difference was no statistically significant （P 〉 0. 05 ）. Conclusion Compared with traditional vaginal hysterectomy, modified vaginal hysterectomy is more effective in the treatment of elderly women with uterine prolapse. Pelvic floor dysfunction is better and quality of life is higher after operation.