盆底重建术治疗盆底障碍性疾病的效果以及患者炎症及应激反应情况

Effect of pelvic floor reconstruction for pelvic floor disease and inflammatory and stress reactions in patients

目的探讨盆底重建术治疗盆底障碍性疾病的效果以及患者炎症及应激反应情况。方法选取2016年1月-2017年7月在温州市中西医结合医院治疗的盆底功能障碍性疾病患者106例,根据最终选取的手术方式分为观察组(56例)和对照组(50例),其中观察组给予盆底重建术治疗,对照组给予骶棘韧带固定术治疗,比较2组治疗前后POP-Q分级、PFDI-20评分,检测治疗前后患者炎症及应激反应指标。结果观察组和对照组治疗后1年POP-Q分级明显优于治疗前(均P<0.05),且观察组治疗后1年POP-Q分级明显优于对照组(P<0.05);观察组和对照组治疗后PFDI-20评分均较治疗前降低(均P<0.05),观察组治疗后3个月PFDI-20评分为(13.24±3.10)分,明显低于对照组(P<0.05)。治疗后24 h,2组皮质醇(COR)、去甲肾上腺素(NE)和前列腺素E2(PGE2)比较差异无统计学意义(均P>0.05);白细胞介素-6(IL-6)和C反应蛋白(CRP)比较差异无统计学意义(均P>0.05)。结论盆底重建术治疗盆底障碍性疾病有较好的效果,对患者炎症及应激反应无明显影响。

Objective To explore the effect of pelvic floor reconstruction in the treatment of pelvic floor disease and the inflammatory and stress reactions of patients. Methods One hundred and six patients with pelvic floor dysfunction treated in our hospital from January 2016 to July 2017 were selected, the patients were divided into observation group(n=56) and control group(n=50) according to the final operation, the observation group was treated with pelvic floor reconstruction, while the control group was treated with sacrospinous ligament fixation, the curative effect of the two groups was observed, the quality of life of the patients was evaluated by PFDI-20, and the indexes of inflammation and stress reaction were detected before and after treatment. Results POP-Q grading in the observation group and the control group at one year after treatment were significantly better than that before treatment(all P<0.05). The POP-Q grading of the observation group at one year after treatment was significantly better than that of the control group, the difference has statistical significance(P<0.05), and the proportion of POP-Q grade 0 to I was 92.86%. The PFDI-20 scores of the observation group and the control group after treatment were lower than those before treatment(all P<0.05). The PFDI-20 score of the observation group at 3 months after treatment was(13.24±3.10) points, which was significantly lower than that of the control group, the difference had statistical significance(P<0.05). There was no significant difference in cortisol(COR), norepinephrine(NE) and prostaglandin E2(PGE2) between the two groups at 24 hours after treatment(all P>0.05). There was no significant difference in interleukin-6(IL-6) and C reactive protein(CRP) between the two groups at 24 hours after treatment(all P>0.05). Conclusion Pelvic floor reconstruction has a better effect in the treatment of pelvic floor disorders, and has no significant effect on inflammation and stress response.