绝经前女性盆底功能障碍性疾病的管理

Management of pelvic floor dysfunction disease in premenopausal women

目的比较患有盆底功能障碍性疾病绝经前女性选择不同治疗方式(未治疗、物理治疗、手术治疗)后临床结局的差异。方法选取2017年1月至2018年6月该院收治的确诊为盆底功能障碍性疾病绝经前女性患者41例,按不同治疗方法分为对照组(未行任何治疗,10例,失访2例)、物理治疗组(11例)和手术组(20例,失访2例)。对照组于首诊后、物理治疗组及手术组于治疗结束后间隔6个月、1年随访,应用盆底功能影响问卷简表(PFIQ-7)评估患者生活质量(评分越低表示生活质量越佳);末次随访使用盆腔器官脱垂定量分度法评估解剖学分度。对比各组患者治疗前后是否有差异。结果对照组患者随访6个月、1年时PFIQ-7评分均明显高于首诊时,物理治疗组及手术组患者随访6个月、1年时PFIQ-7评分均明显低于治疗前,差异均有统计学意义(P<0.05);对照组患者生活质量下降率为75.0%(6/8),物理治疗组及手术组患者生活质量提高率分别为54.5%(6/11)、88.9%(16/18)。对照组患者解剖学加重率为75.0%(6/8),物理治疗组患者解剖学好转率为66.7%(6/9),手术组患者解剖学治愈率为100.0%(18/18)。结论对患有盆底功能障碍性疾病的绝经前女性有必要采取干预措施延缓疾病的发展,提高患者生活质量。

Objective To compare the difference of clinical outcomes among different treatment methods(no treatment,physical therapy,surgical treatment)selected by premenopausal females with pelvic floor dysfunction disease.Methods Forty-one premenopausal women with pelvic floor dysfunction disease in the hospital from January 2017 to June 2018 were selected and divided into the control group(no treatment,10 cases,2 cases of lose to follow up),physiotherapy group(10 cases)and operation group(20 cases,2 cases of lose to follow up).The quality of life was evaluated by using the pelvic floor function impact questionnaire-short form 7(PFIQ-7)in the control group after the first diagnosis,the physiotherapy group and the operation group at 6-month interval and 1-year follow up;at the last follow-up,the pelvic organ prolapse quantitation(POP-Q)was used to assess their anatomy degree.The differences between before and after treatment were compared among various groups.Results The PFIQ-7 score at 6-month,1-year follow up in the control group were significant higher than those at first visit to doctor.The PFIQ score at 6-month,1-year follow up in the physiotherapy group and operation group was significantly lower than that before treatment,and the differences were statistically significant(P<0.05);the reduction rate of life quality in the control group was 75.0%(6/8),and the increase rates of life quality in the physiotherapy group and operation group were 66.7%(6/9)and 88.9%(16/18)respectively.As for anatomical degree,the aggravation rate of it in the control group was 75.0%(6/8).The improvement rate of it in the physiotherapy group was 66.7%(6/9),and the cure rate in the operation group was 100.0%(18/18).Conclusion It is necessary to adopt the interventional measures to delay the development of the disease and improve the quality of life for premenopausal women with pelvic floor dysfunction.