重度盆腔器官脱垂女性老年患者以阴道封闭术治疗的临床效果

Analysis of the Clinical Effect of Vaginal Closure in Elderly Female Patients with Severe Pelvic Organ Prolapse

目的:讨论重度盆腔器官脱垂女性老年患者以阴道封闭术治疗的临床效果。方法:选取2017年12月-2018年12月笔者所在医院收治的60例重度盆腔器官脱垂女性老年患者,均接受阴道封闭术(全阴道封闭术/部分阴道封闭术)治疗。观察并发症发生情况、术后随访结果。结果:术后并发症发生率为3.33%。60例患者中,术前排尿困难31例,排便困难5例,压力性尿失禁17例;经手术治疗后,27例能自主顺利排尿,4例排便困难明显缓解,15例压力性尿失禁明显好转。术后随访1年,随访患者人数52例,失访8例。无一例复发,POP-Q分期Ⅰ期及以下,客观成功率100%。术后1年的阴裂长度、阴道长度均短于术前,且会阴体长度大于术前,差异均有统计学意义(P<0.05)。结论:重度盆腔器官脱垂女性老年患者以阴道封闭术治疗,可改善盆腔器官脱垂,缓解排尿排便困难,从而提高患者生活质量,并发症发生率、复发率均较低,是一项疗效稳定、安全的有效术式。

Objective:To investigate the clinical effect of vaginal closure in elderly female patients with severe pelvic organ prolapse.Method:From December 2017 to December 2018,60 elderly female patients with severe pelvic organ prolapse admitted in our hospital were selected.All of them were treated with vaginal closure(total vaginal closure/partial vaginal closure).The complications and postoperative follow-up results were observed.Result:The incidence of postoperative complications was 3.33%.Among the 60 patients,there were 31 cases of dysuria,5 cases of dysdefecation and 17 cases of stress urinary incontinence before operation.After operation,27 cases were able to urinate smoothly,4 cases had obvious relief of dysdefecation,and 15 cases of stress urinary incontinence were significantly improved.After 1 year of postoperative follow-up,52 patients were followed up and 8 cases were lost to follow-up.There was no recurrence.The POP-Q stage was stageⅠand below,and the objective success rate was 100%.The length of vaginal fissure and the length of the vagina at 1 year after operation were shorter than those before operation,and the length of perineal body was larger than that before operation,the differences were statistically significant(P<0.05).Conclusion:For elderly female patients with severe pelvic organ prolapse,vaginal closure can improve pelvic organ prolapse,relieve difficulty in urination and defecation,thus improving the quality of life of the patients.The incidence of complications and recurrence rate are low,and it is an effective operation with stable efficacy and safety.