改良盆底重建术对盆腔脏器脱垂患者盆底功能及近期预后的影响

Effect of modified pelvic floor reconstructive surgery on pelvic floor function and short-term prognosis of patients with pelvic organ prolapse

目的探究改良盆底重建术对盆腔脏器脱垂患者盆底功能及近期预后的影响。方法回顾性分析2016年7月-2017年12月本院确诊为盆腔脏器脱垂(POP)64例患者的临床资料,依据手术方式的不同,将患者分为观察组(n=36)和对照组(n=28)两组,对照组患者采用传统阴式子宫切除+阴道前后壁修补,观察组患者采用改良式盆底重建术治疗。对比两组患者治疗后的临床疗效、围手术期相关指标、术后并发症情况及近期预后情况。结果与术前相比,两组患者术后6个月POP-Q各点水平均有明显改善,且观察组优于对照组(P<0.05)。观察组住院时间明显短于对照组(P<0.05)。观察组术后并发症发生率显著低于对照组(P<0.05),复发率也低于对照组,但差异不具有统计学意义(P>0.05)。与术前相比,两组患者术后6个月和12个月的P-QOL评分均有明显降低,且观察组降低幅度明显优于对照组(P<0.05)。结论改良盆底重建术治疗POP效果更好,能明显的改善患者盆底功能,还能明显提高患者生活质量,且安全性高,更有利于患者预后,值得临床推广。

Objective To investigate the effect of modified pelvic floor reconstruction on pelvic floor function and short-term prognosis of patients with pelvic organ prolapse( POP). Methods The clinical data of64 patients with pelvic organ prolapse( POP) diagnosed in our hospital from July 2016 to December 2017 were retrospectively analyzed. The patients were divided into observation group( n = 36) and control group( n = 28)according to different surgical methods. The patients in control group were treated with traditional vaginal hysterectomy plus vaginal anterior and posterior wall repair. The patients in observation group were treated with modified pelvic floor reconstruction. The clinical efficacy,perioperative indicators,postoperative complications and short-term prognosis of the two groups were compared. Results The levels of POP-Q in both groups were significantly improved at 6 months after operation,and the levels in observation group were superior to the control group( P<0.05). The hospital stay of the observation group was significantly shorter than that of the control group( P<0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group( P< 0.05),and the recurrence rate was also lower than that in the control group,without statistically significant difference( P>0.05). The P-QOL scores of both groups were significantly decreased at 6 and 12 months after operation,and the reduction was significantly better in the observation group( P < 0. 05).Conclusions Modified pelvic floor reconstruction is more effective for treating POP. It could significantly improve the pelvic floor function and quality of life of patients. It is safer and more conducive to the prognosis of patients. It is worthy of clinical promotion.