阴道封闭术治疗老年重度盆腔器官膨出的临床效果及对排尿和排便症状的影响分析

Clinical effect of colpocleisis in the treatment of severe pelvic organ prolapse in the elderly and its influence on urination and defecation symptoms

目的探讨阴道封闭术治疗老年重度盆腔器官膨出的临床效果及对排尿和排便症状的影响。方法10例老年重度盆腔器官膨出患者,随机分为对照组和研究组,每组5例。对照组患者采用子宫切除术治疗,研究组患者采用阴道封闭术治疗。对比两组患者手术指标、术后指标、手术前后生活质量及手术后排尿、排便症状恢复情况。结果研究组患者手术时间(109.6±21.6)min、保留导尿管时间(5.2±0.5)d均短于对照组的(124.3±26.7)min、(6.3±0.6)d,术中出血量(105.6±26.5)ml及术后残余尿量(10.6±2.1)ml少于对照组的(163.7±37.4)、(18.6±2.6)ml,差异具有统计学意义(P<0.05)。手术前,两组患者盆底障碍影响简易问卷7(PFIQ-7)评分、盆底功能障碍简表20(PFDI-20)评分比较差异无统计学意义(P>0.05);手术后,两组患者PFIQ-7评分、PFDI-20评分均低于本组手术前,且研究组PFIQ-7评分(9.5±4.5)分、PFDI-20评分(9.5±2.8)分均低于对照组的(15.7±2.1)、(13.7±2.4)分,差异具有统计学意义(P<0.05)。手术后,研究组患者排尿困难、压力性尿失禁、排便困难、刺激症状恢复情况明显优于对照组,差异具有统计学意义(P<0.05)。结论老年重度盆腔器官膨出患者应用阴道封闭术手术时间短,出血量少,手术安全可靠,能够提高排便、排尿能力,临床上应当进一步推广应用。

Objective To discuss the clinical effect of colpocleisis in the treatment of severe pelvic organ prolapse in the elderly and its influence on urination and defecation symptoms.Methods A total of 10 elderly patients with severe pelvic organ prolapse were randomly divided into control group and research group,with 5 cases in each group.The control group was treated with hysterectomy,and the research group was treated with colpocleisis.Comparison was made on surgical indicators,postoperative indicators,quality of life,recovery of urination and defecation symptoms before and after operation between the two groups.Results The operation time(109.6±21.6)min,retention time of catheter(5.2±0.5)d in the research group was shorter than(6.3±0.6)min and(124.3±26.7)d in the control group.The amount of intraoperative hemorrhage(105.6±26.5)ml and amount of postoperative residual urine(10.6±2.1)ml was less than(163.7±37.4)and(18.6±2.6)ml in the control group.Their difference was statistically significant(P<0.05).Before operation,there was no statistically significant difference in pelvic floor impact questionnaire(PFIQ-7)and pelvic floor distress inventory(PFDI-20)between the two groups(P>0.05).After treatment,the PFIQ-7 score and PFDI-20 score in the two groups was lower than those before treatment.The PFIQ-7 score(9.5±4.5)points and PFDI-20 score(9.5±2.8)points in the research group was lower than(15.7±2.1)and(13.7±2.4)points in the control group,and their difference was statistically significant(P<0.05).After treatment,the rehabilitation of dysuria,stress urinary incontinence,difficulty in defecation and irritation symptoms in the research group was obviously better than those in the control group,and their difference was statistically significant(P<0.05).Conclusion Colpocleisis is safe and reliable in elderly patients with severe pelvic organ prolapse.It can improve the ability of defecation and urination,and should be further popularized and applied in clinic.