改良阴道前后壁修补术治疗盆腔脏器脱垂的疗效分析

Curative effect of modified vaginal anterior and posterior wall repair in the treatment of pelvic organ prolapse

目的探索改良阴道前后壁修补术与传统阴道前后壁修补术治疗盆腔脏器脱垂(POP)的疗效及对术后性功能的影响。方法选取行改良阴道前后壁修补术治疗的120例POP患者为观察组,另选取行传统阴道前后壁修补术治疗的120例POP患者为对照组,比较2组手术相关指标、盆底功能障碍问卷简表20(PFDI-20)评分、女性性功能指数(FSFI)评分、盆腔脏器脱垂-Q分期(POP-Q)各标志点值、并发症发生情况,同时随访统计复发率。结果观察组胃肠道功能恢复时间、住院时间短于对照组,治疗费用少于对照组,差异均有统计学意义(P<0.05),2组手术时间、术中出血量比较差异无统计学意义(P>0.05);观察组术后1周、6个月PFDI-20评分均低于对照组(P<0.05);观察组术后3个月的性生活满意度、性高潮、阴道润滑度、性交痛、性兴奋、性欲望评分优于对照组(P<0.05);观察组术后6个月的Ap、Ba、Aa、C改善情况优于对照组(P<0.05);观察组术后3个月、6个月、12个月的复发率及术后并发症发生率均低于对照组(P<0.05)。结论对POP患者实施改良阴道前后壁修补术治疗,可明显改善术后生活质量,降低术后复发率。

Objective To explore the curative effects of modified vaginal anterior and posterior wall repair and traditional vaginal anterior and posterior wall repair in the treatment of pelvic organ prolapse(POP)and their effect on postoperative sexual function.Methods A total of 120 POP patients who underwent modified vaginal anterior and posterior wall repair were selected as the observation group,and 120 POP patients who underwent traditional vaginal anterior and posterior wall repair were selected as the control group.The operation-related indicators,the pelvic floor distress inventory short form 20(PFDI-20)score,female sexual function index(FSFI)score,pelvic organ prolapse quantitation(POP-Q)marker values,and complication incidence were compared between the two groups,and the recurrence rate was collected during follow-up.Results The recovery time of gastrointestinal function and hospital stay in the observation group were shorter than those in the control group,and the treatment cost was less than that in the control group,the differences were statistically significant(P<0.05).There was no statistically significant difference in the operation time or intraoperative bleeding between the two groups(P>0.05).The PFDI-20 scores 1 week and 6 months after operation in the observation group were lower than those in the control group(P<0.05).The scores of sexual life satisfaction,orgasm,vaginal lubrication,dyspareunia,sexual excitement and sexual desire 3 months after operation in the observation group were better than those in the control group(P<0.05).The improvements of Ap,Ba,Aa and C 6 months after operation in the observation group were better than those in the control group(P<0.05).The recurrence rates 3 months,6 months and 12 months after operation and postoperative complication rate in the observation group were lower than those in the control group(P<0.05).ConclusionModified vaginal anterior and posterior wall repair for POP patients can significantly improve the postoperative quality of life and reduce the postoperative recurrence rate.