摘要
目的:分析阴道盆底重建术联合经闭孔途径聚丙烯网带尿道中段悬吊术(TVT-O)治疗子宫脱垂患者临床疗效及对盆底功能和尿动力学指标的影响。方法:选取2019年1月—2020年1月本院收治的子宫脱垂患者133例,根据手术治疗方式不同分为对照组(阴道盆底重建术+经耻骨后尿道中段悬吊术(TVT))64例与观察组(阴道盆底重建术+TVT-O)69例,对比两组治疗后6个月临床疗效、盆底功能、尿动力学、并发症以及复发率。结果:术后观察组总有效率(92.8%)高于对照组(81.3%),复发率(1.5%)低于对照组(9.4%),两组盆底功能评分、尿动力指标均降低且观察组PFIQ-7(38.5±11.3分)、PFDI-20(28.6±9.3分)低于对照组(59.7±11.36分、49.7±10.5分),PVR(3.39±0.70 ml)、Qmax(18.40±3.13 ml/s)低于对照组(3.87±0.73 ml、21.58±3.27 ml/s),并发症总发生率观察组(5.8%)低于对照组(17.2%)(均P<0.05)。结论:阴道盆底重建术联合TVT-O治疗子宫脱垂者临床疗效更佳,可更好改善患者盆底功能以及尿动力学指标,对患者术后康复有积极影响。
Objective:To analyze the clinical efficacy of vaginal pelvic floor reconstruction operation combined with middle urethral suspension with polypropylene mesh through obturator approach(TVT-O)for treating women with uterine prolapsed,and to study its influence on their pelvic floor function and urodynamics.Methods:133 women with uterine prolapse were selected and were divided into observation group and control group according to different surgery from January 2019 to January 2020.69 women in the observation group were given vaginal pelvic floor reconstruction combined with TVT-O,and 64 women in the control group were given vaginal pelvic floor reconstruction combined posterior pubic urethral suspension(TVT).The clinical efficacy,the pelvic floor function,the urodynamics,and the rates of complications and recurrence of the women 6 months after treatment were compared between the two groups.Results:The total postoperative effective rate(92.8%)of the women in the observation group was significant higher than that(81.3%)of the women in the control group,but the recurrence rate(1.5%)of the women in the observation group was significant lower than that(9.4%)of the women in the control group.The pelvic floor functional score and urine dynamics indexes of the women in the two groups had decreased significantly after treatment.The PFIQ-7 score(38.5±11.3 points)and PFDI-20 score(28.6±9.3 points)of the women in the observation group were significant lower than those(59.7±11.36 points and 49.7±10.5 points)of the women in the control group.The values of PVR(3.39±0.70 ml)and Qmax(18.40±3.13 ml/s)of the women in the observation group were significant lower than those(3.87±0.73 ml and 21.58±3.27 ml/s)of the women in the control group.The incidence of total complications(5.8%)of the women in the observation group was significant lower than that(17.2%)of the women in the control group(P<0.05).Conclusion:Vaginal pelvic floor reconstruction operation combined with TVT-O for treating the women with uterine prolapse has better clinical effect,which can significantly improve their pelvic floor function and urodynamics,and has positive impact on the postoperative rehabilitation of the women.
作者
王英
简燕琳
李成利
WANG Ying;JIAN Yanlin;LI Chengli(The Third Affiliated Hospital of Chengdu Medical College, Pidu District People's Hospital of Chengdu, Chengdu, Sichuan Province, 611730)
出处
《中国计划生育学杂志》
2021年第9期1873-1876,1880,共5页
Chinese Journal of Family Planning
基金
四川医事卫生法治科研课题(YF19-Y18)。
关键词
子宫脱垂
阴道盆底重建术
聚丙烯网带尿道中段悬吊术
盆底功能
尿动力学
术后康复
Uterine prolapse
Vaginal pelvic floor reconstruction
Middle urethral suspension with polypropylene mesh through obturator approach
Pelvic floor function
Urodynamics
Postoperative rehabilitation
