影响HUS治疗产后Ⅲ~Ⅳ度盆腔脏器脱垂效果的因素分析

Factors analysis on the effect of HUS therapy on postpartum gradeⅢ~Ⅳpelvic organ prolapse

目的分析影响腹腔镜下高位骶韧带悬吊(HUS)治疗产后Ⅲ~Ⅳ度盆腔脏器脱垂(POP)效果的相关因素。方法从中国人民解放军联勤保障部队第九〇三医院妇产科资料库中调取2019年8月至2022年8月行HUS的产后Ⅲ~Ⅳ度POP患者的病历资料进行回顾性研究,根据术后1年的临床疗效将患者分为无效组(n=26)和有效组(n=188)。收集两组资料,分析影响HUS治疗产后Ⅲ~Ⅳ度POP效果的因素。结果经单因素、多因素Logistic回归分析显示,阴道分娩史(OR=11.909)、血清松弛素水平异常升高(OR=1.167)、基质金属蛋白酶-1(MMP-1)水平异常升高(OR=11.656)是影响HUS治疗产后Ⅲ~Ⅳ度POP效果的危险因素,而术后规律性生活(OR=0.043)则是保护因素。结论HUS治疗产后Ⅲ~Ⅳ度POP效果受阴道分娩次数、术后规律性生活、血清松弛素及MMP-1水平等综合因素的影响,建议针对性早期宣教及干预性治疗,以提高手术治疗效果。

Objective To analyze the relevant factors that affect the effectiveness of high uterineeaezeligatlon suspensien(HUS)in treating postpartum stageⅢ~Ⅳpelvic organ prolapse(POP).Methods The medical records of postpartum patients with gradeⅢ~ⅣPOP who were admitted to the hospital for HUS from August 2019 to August 2022 in the obstetrics and gynecology database of 903 Hospital of the Chinese People's Liberation Army Joint Logistic Support Force were retrieved for retrospective study.The patients were divided into the ineffective group(n=26)and the effective group(n=188)according to the clinical efficacy one year after surgery.The data of the two groups were collected to analyze the factors affecting the effect of HUS in the treatment of postpartumⅢ~ⅣPOP.Results Univariate and multivariate Logistic regression analysis showed that history of vaginal delivery(OR=11.909),abnormal increase of serum relaxin level(OR=1.167)and abnormal increase of matrix metalloproteinase-1(MMP-1)level(OR=11.656)were risk factors affecting the effect of HUS in the treatment of postpartumⅢ~ⅣPOP,while regular sexual activity after surgery(OR=0.043)was a protective factor.Conclusions The effectiveness of HUS in the treatment of postpartum stageⅢ~ⅣPOP is influenced by comprehensive factors such as vaginal delivery frequency,postoperative regular lifestyle,serum relaxin and MMP-1 levels.It is recommended to provide targeted early education and intervention treatment to improve the effect of surgical treatment.