盆腔脏器脱垂98例术后疗效评价

Evaluation on postoperative curative effect of pelvic organ prolapse in 98 cases

摘要:

目的：评价盆腔脏器脱垂（Pelvic organ prolapse，POP）手术治疗后疗效，分析术后复发的危险因素，并评价传统手术与Prolift系统盆底重建术的疗效和安全性。方法：对2008年1月至2009年6月收治的98例盆腔脱垂患者首次行手术治疗的病例进行回顾性研究和随访记录分析，依据随访检查结果判断治愈和复发。对复发组和治愈组的年龄、体重指数、孕产次、分娩方式、绝经与否、随访时间、慢性疾病、术前子宫脱垂程度指标以及手术方式进行差异显著性分析。结果：治愈率86.73%（85/98）、复发率13.27%（13/98），术后复发组与治愈组间在年龄、产次、慢性咳嗽、便秘、子宫脱垂程度、体重指数、孕次、随访时间、分娩方式、术前绝经间无显著性差异，而在传统手术与Prolift系统盆底重建术的手术方式之间呈显著差异。结论：阴式全子宫切除、阴道前后壁修补、会阴修补等传统手术有较高的复发率，Prolift系统盆底重建术明显降低了术后复发率，能更好的修补缺陷，恢复盆底结构，短期疗效安全可行。

Abstract:

Objective：To analyze the postoperative curative effect on pelvic organ prolapse（POP） and the risk factors of postoperative recurrences and to assess the safety and effectiveness of traditional surgery and Prolift pelvic floor reconstruction. Methods：Retrospec－tive study and follow-up analysis were carried out in 98 patients with prolapsed pelvic organ who received the surgery at the first time from January 2008 to June 2009. The cure and recurrence were determined according to the follow-up results. Statistical analysis was conducted concerning the age，body mass index，maternal time，delivery mode，menopause condition，follow-up time，chronic diseases，indicators of the degree of preoperative uterine prolapse and the surgical approach between cure group and recurrence group. Results：The cure rate was 86.73%（85/98） and the recurrence rate was 13.27%（13/98）. There was no difference in the age，parity，chronic cough，constipation，prolapse of the uterus，body mass index，gravidity，follow-up time，delivery mode and the pre-menopause condi－tion between cure group and recurrence group. However，significant differences were observed in the operational approach between the traditional operation and Prolift pelvic floor reconstruction. Conclusions：Vaginal hysterectomy，anterior and posterior vaginal repair，perineal repair and other traditional surgery have higher recurrence rate. Prolift pelvic floor reconstruction can significantly reduce the recurrence rate，better repair the defects and restore the pelvic floor structures，therefore it is feasible and safe in light of the short-term efficacy.