盆底肌瑜伽联合TVT-O治疗盆腔器官脱垂合并下尿路症状患者的临床疗效

The Value of Pelvic Floor Yoga Combined with TVT-O Surgery in the Treatment of Pelvic Organ Prolapse with Lower Urinary Tract Symptoms

【目的】探讨盆底肌瑜伽联合经闭孔尿道中段无张力悬吊带术(TVT-O)治疗盆腔器官脱垂(POP)合并下尿路症状患者的临床疗效。【方法】选择2019年1月至2022年1月蒲城县医院妇科收治的83例POP合并下尿路症状患者,按照随机数字表法分为观察组(n=42)和对照组(n=41),两组均行改进盆底重建手术,对照组在手术中加用TVT-O,观察组在对照组基础上加用盆底肌瑜伽干预。比较两组临床疗效、围术期各项指标(手术时间、出血量、术后残余尿量、尿管留置时间、术后24 h体温、住院时间)、术后并发症发生情况及手术前后下尿路症状改善情况、盆底功能[盆底障碍影响简易问卷(PFIQ-7)、盆底功能障碍量表(PFDI-20)、盆底器官脱垂和尿失禁性功能调查问卷(PISQ-12)]评分。【结果】观察组总有效率为97.62%,与对照组的92.68%比较,差异无统计学意义(P>0.05);两组围术期指标比较,差异无统计学意义(P>0.05);手术后,两组下尿路症状明显优于手术前(P<0.05),且观察组下尿路症状改善优于对照组(P<0.05);手术后,两组PFIQ-7评分、PFDI-20评分均低于手术前,PISQ-12评分高于手术前(P<0.05),且观察组PFIQ-7评分、PFDI-20评分低于对照组,PISQ-12评分高于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05)。【结论】盆底肌瑜伽联合TVT-O治疗POP合并下尿路症状患者,临床效果显著,可有效改善患者下尿路症状和盆底功能障碍,促进患者盆底功能恢复,可有效降低并发症发生率,值得临床推广应用。

【Objective】To explore the value of pelvic floor yoga combined with tension-free vaginal tape-obturator(TVT-O)in the treatment of pelvic organ prolapse(POP)with lower urinary tract symptoms.【Methods】A total of 83 patients with pelvic organ prolapse(POP)combined with lower urinary tract symptoms who were admitted to our hospital from January 2019 to January 2022 were selected as the subjects of the study.They were randomly divided into the observation group of 42 cases and the control group of 41 cases.Both groups underwent modified pelvic floor reconstruction surgery.The control group used TVT-O surgery during the operation.The observation group added pelvic floor muscle yoga for intervention after the same surgical method as the control group.The clinical efficacy,perioperative indicators[operation time,blood loss,postoperative residual urine volume,urinary catheter indwelling time,24-hour postoperative body temperature,hospital stay],the improvement of lower urinary tract symptoms before and after the operation,pre-and postoperative pelvic floor function scores[pelvic floor impact questionnaire(PFIQ-7),pelvic floor distress inventory(PFDI-20),pelvic organ prolapse/urinary incontinence sexual function questionnaire(PISQ-12)],as well as postoperative complications and recurrence were compared between the two groups.【Results】The overall effectiveness rate of the observation group was 97.62%,which was significantly higher than the 85.37%in the control group(P<0.05).There was no significant difference in the perioperative indicators between the two groups(P>0.05).The lower urinary tract symptoms in both groups got significantly improved after surgery compared to before surgery(P<0.05),and the improvement in the observation group was better than that in the control group(P<0.05).After surgery,the PFIQ-7 and PFDI-20 scores in both groups were lower than before surgery,and PISQ-12 scores were higher than before surgery(P<0.05).Furthermore,the PFIQ-7 and PFDI-20 scores in the observation group were lower than those in the control group,while PISQ-12 score in the observation group was higher than that in the control(P<0.05).The incidence of complications and recurrence in the observation group was lower than that in the control group(P<0.05).【Conclusion】The clinical effect of combining pelvic floor muscle yoga with TVT-O surgery in the treatment of pelvic organ prolapse and lower urinary tract symptoms is significant.It can effectively improve patients'lower urinary tract symptoms and pelvic floor dysfunction,promote the recovery of pelvic floor function,effectively reduce complications,avoid recurrence,and is worth promoting in clinical practice.