改良式前盆底重建术治疗盆腔器官脱垂临床研究

CLINICAL ANALYSIS OF MODIFIED PRIMARY ANTERIOR PELVIC RECONSTRUCTION IN TREATING 51 CASES OF PELVIC ORGAN PROLAPSE

目的:探讨改良式前盆底重建术治疗盆腔器官脱垂的临床应用前景。方法:回顾性分析于2012-09～2015-08期间内蒙古自治区人民医院妇科行改良式前盆底重建术治疗盆腔器官脱垂并按期随访的51例病人的临床资料,根据盆腔器官脱垂定量(pelvic organ prolapse quantification,POP-Q)分期,所有病人均≥Ⅲ期,且以前、中盆腔脱垂为主,合并或不合并后盆腔脱垂,均行改良式前盆底重建术,于术后进行主、客观疗效评价及术后并发症的分析。结果:51例病人年龄为62±8岁;绝经50例(98.04%,50/51),术前均无激素替代治疗;自然分娩次数2.65±1.23次,手术时间为87.23±36.45 min。本研究中客观治愈率高达100%,主观满意率96.08%,术后侵蚀率为17.65%。结论:改良式前盆底重建术治疗盆腔器官脱垂治愈率高,并且具有简单、快速、创伤小、高效、费用低的特点,临床应用前景广阔。

Objective： To discuss the clinical value of the modified primary anterior pelvic reconstruction in treating pelvic organ prolapsed （POP）. Methods： The clinical data of 51 cases of severe POP, who were treated mainly with modified pelvic reconstruction between September 2012 and August 2015 in Inner Mongolia People’s Hospital, were retrospectively analyzed. According to Pelvic Organ Prolapse Quantification（POP-Q） system, all patients expressed as primarily anterior and middle POP, no matter withor without posterior POP, stage Ⅲ or higher, were all treated by the modified primary anterior pelvic reconstruction. The data of postoperative subjective and objective of the patients and complications were retrospectively analyzed. Results： In this study, the average age of patients was 62±8 years old, with menopause as 50（ 98.04 %,50/51）and no hormone was used before the surgey. The nature delivery times was 2.65 ± 1.23 , and the average operative time was 87.23 ± 36.45 min. After the surgey, the objective cure rate were 100% with subjective satisfaction rate as 96.08 % and the postoperative erosion？rate as 17.65 %. Conclusion： In our retrospective study, the modified primary pelvic reconstructions achieve considerable subjective and objective cure rates in treating POP patients with the characteristics of safe, simple, effective, and cheap. And the modified primary pelvic reconstructions explore extensive potential clinical applications.