Y网应用于腹腔镜下阴道骶骨固定术对尿流动力学、膀胱功能的影响及疗效评价

Effect of Artisyn-Y shape mesh use in laparoscopic sacrocolpopexy on female urodynamics and bladder function

目的研究部分可吸收Artisyn-Y型网片用于腹腔镜下阴道骶骨固定术对盆腔脏器脱垂患者尿流动力学、膀胱功能的影响及其疗效评价。方法选取2018年7月至2020年1月深圳市妇幼保健院收治的盆腔脏器脱垂(POP)患者110例,根据手术方式将患者分为两组采用部分可吸收性Y型网片行腹腔镜阴道骶骨固定术的患者为观察组(55例);采用传统盆底重建手术(阴式全子宫切除+阴道前后壁修补)的患者为对照组(55例)。比较两组患者手术前一般临床资料、手术后尿流动力学、膀胱功能的变化。通过盆腔脏器脱垂/尿失禁性功能问卷(PISQ-12)、盆底功能障碍性疾病症状问卷简表(PFDI-20)等问卷评价术后生活质量、性生活改善情况。结果观察组的手术时间较对照组长,差异有统计学意义(P<0.05)。两组的术中出血量比较,差异无统计学意义(P>0.05)。术后半年,两组的平均尿流率、最大尿流率、残余尿量及最大膀胱容量均有所改善,且观察组优于对照组(P<0.05)。术后两组的POPDI-6、UDI-6、CRADI-8及PFIQ-7评分均显著改善,观察组术后半年、1年时显著低于对照组(P<0.05)。两组患者术后的盆底生活质量、性生活质量评分均较术前改善,且观察组的盆底生活质量、性生活质量高于对照组(P<0.05)。结论部分可吸收性Y网应用于腹腔镜下阴道骶骨固定术治疗盆腔脏器脱垂患者安全有效,可有效改善患者尿流动力学、膀胱功能,值得临床应用及推广。

Objective:To assess the effectiveness of using Artisyn-Y shape mesh use in laparoscopic sacrocolpopexy on symptomatic pelvic organ prolapse patients'urodynamics and bladder function.Methods:110 patients of pelvic organ prolapse underwent surgery were analyzed from July 2018 to January 2020 in Shenzhen Maternal&Child Healthcare Hospital Affiliated to Southern Medical University.55 patients who underwent laparoscopic sacral colpopexy with the use of Artisyn-Y shape mesh were divided into observation group.55 patients underwent traditional operation were defined as control group.Preoperative data,operation parameters,postoperative complications,the postoperative urodynamics and bladder function were evaluated between the two groups.Subjective effects were assessed by comparing pelvic floor distress inventory-short form 20(PFDI-20),pelvic organ prolapse/urinary incontinence sexual questionnaire-12(PISQ-12).Results:The mean operation time was longer in the observation group than that in the control group(P<0.05).Average flow rate、maximum flow rate、residual urine and maximum bladder caparity in the two groups were significantly improved half year postoperation(P<0.05).These parameters in observation group were significantly better than that in control group(P<0.05).After 6 months and 12 months treatment,POPDI-6 points、UDI-6 points、CRADI-8 points and PFIQ-7 points in observation group were lower than those in control group(P<0.05).Postoperative quality of life and sexual were improved in both group,but those in observation group was better than that in control group(P<0.05).Conclusions:The partially absorbable Artisyn-Y shape mesh use in laparoscopic sacral colpopexy is safe and effective ways for symptomatic pelvic organ prolapse patients,and significantly improve the quality of female urodynamics and bladder function.