盆底重建术治疗老年妇女子宫脱垂的疗效及对病人生活质量的影响

Effect of pelvic floor reconstruction on uterine prolapse and patients' quality of life in elderly women

目的观察盆底重建术治疗老年妇女子宫脱垂的疗效,并探讨其对病人生活质量的影响。方法将116例子宫脱垂老年病人随机分为观察组和对照组,每组58例;观察组病人采用盆底重建术进行治疗,对照组病人采用阴式子宫切除联合阴道前后壁修补术进行治疗。比较2组在手术情况、治疗效果及生活质量方面的差异。结果观察组的手术时间、术中出血量及住院时间均明显优于对照组(P<0.05);治疗后,观察组盆腔器官脱垂定量(POP-Q)各指示点测量值的改善程度均较对照组更显著(P<0.05);术后3个月、6个月、1年时,观察组的盆底障碍影响简易问卷7(PFIQ-7)评分均较治疗前显著降低,且明显低于对照组相同时间点(P<0.05);术后1年,观察组的复发率(0)明显低于对照组(10.34%)(P<0.05),但2组术后并发症发生率差异无统计学意义(P>0.05)。结论盆底重建术治疗老年子宫脱垂疗效显著,术后复发率低,且其对病人生活质量的改善效果优于阴式子宫切除联合阴道前后壁修补术。

Objective To observe the effect of pelvic floor reconstruction in the treatment of uterine prolapse in elderly women,and to explore its influence on the patients＇ quality of life（ QOL）.Methods A total of 116 elderly women with uterine prolapse were randomly divided into observation group（ n = 58） and control group（ n = 58）. Patients in the observation group were treated by pelvic floor reconstruction,and patients in the control group were treated by transvaginal hysterectomy（ TVH）combined with colporrhaphia anterior-posterior. The situation of operation, clinical effect and QOL between the two groups were compared. Results The operation time,bleeding volume and length of stay in the observation group were obviously better than those in the control group（ P〈0. 05）. After operation,the improvement of POP-Q in the observation group was significantly better than that in the control group（ P〈0. 05）. Three months,6 months and 1 year after operation,the scores of pelvic floor impact questionnaire 7（ PFIQ-7） in the observation group were significantly lower than those before operation and those at the same time in the control group（ P〈0. 05）. One year after operation,the recurrence rate（ 0） in the observation group was significantly lower than that in the control group（ 10. 34%）（ P〈0. 05）. However,no significant difference was found in the incidence of postoperative complications between the two groups（ P〉0. 05）. Conclusions Pelvic floor reconstruction has an obvious effect and a low postoperative recurrence rate for the treatment of senile uterine prolapse,and it could improve QOL more significantly than TVH combined with colporrhaphia anterior-posterior.