[1]黄润强*,杨帆,方彩云,等.全盆底重建术治疗重度盆腔器官脱垂的近期疗效 及安全性分析[J].中国计划生育和妇产科,2017,(2):51- 54,78.
　HUANG Run-qiang*,YANG Fan,FANG Cai-yun,et al.Recent effectiveness and safety analysis of total pelvic reconstruction surgery for repair of severe pelvic organ prolapse[J].Chinese Journal of Family Planning & Gynecotokology,2017,(2):51- 54,78.
点击复制

全盆底重建术治疗重度盆腔器官脱垂的近期疗效 及安全性分析
分享到：

《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2017年2期
页码:
51- 54,78
栏目:
论著与临床
出版日期:
2017-02-25

文章信息/Info

Title:
Recent effectiveness and safety analysis of total pelvic reconstruction surgery for repair of severe pelvic organ prolapse
作者:
黄润强1*; 杨帆2; 方彩云1; 熊平安1; 张春莲1
湖北省十堰市太和医院(湖北医药学院附属医院)1.妇科2病区；2. 中心手术室妇泌组
Author(s):
HUANG Run-qiang1*; YANG Fan2; FANG Cai-yun1; XIONG Ping-an1; ZHANG Chun-lian1
1. Department of Gynecology,2.Central Operation Room，Shiyan Taihe Hospital of Hubei province（Affiliated Hospital of Hubei Medical College)，Shiyan Hubei 442000，P.R.China
关键词:
全盆底重建术; 重度盆腔器官脱垂; 疗效; 安全性; 尿潴留
Keywords:
total pelvic reconstruction surgery; severe pelvic organ prolapse;  effectiveness and safety;  uroschesis
分类号:
R 7112
摘要:
目的探讨全盆底重建术治疗女性重度盆腔器官脱垂的近期疗效及安全性。方法回顾性分析湖北省十堰市太和医院2009年12月至2013年12月接受全盆底重建术治疗的重度盆腔器官脱垂56例患者的临床资料，术后定期随访，通过盆腔器官脱垂定量检查法(pelvic organ prolapse quantitation，POP–Q)分期评价解剖疗效，盆底功能影响问卷-简表7（pelvic floor impact questionnaire - 7,PFIQ–7）、盆底功能障碍问卷-20（pelvic floor distress inventory- 20，PFDI–20）和POP–尿失禁性生活问卷–12（pelvic organ prolapse/urinary incontinence sexual questionnaire-12,PISQ–12）三种生活质量和性生活问卷评价功能疗效，从而分析全盆底重建术的近期疗效及安全性。结果手术均进行顺利，术中术后均无输血，无直肠、膀胱、尿道、血管及神经等损伤。除1例术后尿潴留外, 其余均1~ 2 d恢复自主排尿，近期并发症为17%（1/56）。2例网片侵蚀，远期并发症为35 %（2/56）。术后1年主、客观治愈率均为100 %。PFIQ–7和PFDI–20评分显示术后生活质量较术前显著提高(t分别=1669、1921，P=0000)，而性生活质量改善不大(t=0124，P=0613 )。结论全盆底重建术用于纠正重度盆腔器官脱垂，手术安全、创伤小、解剖和功能恢复率高，复发率低，能显著改善患者的生活质量，对性生活质量影响不大，近期疗效及安全性肯定，值得临床上进一步推广。
Abstract:
ObjectiveTo evaluate recent effectiveness and safety of total pelvic reconstruction surgery for repair of severe pelvic organ prolapse（POP）.MethodsAnalyzed the clinical data of 56 patients with severe POP in Shiyan Taihe Hospital of Hubei province from Dec. 2009 to Dec. 2013 retrospectively ，and the patients were followed regularly after surgery. The anatomical outcomes were evaluated by pelvic organ prolapse quantitation(POP-Q), functional effectiveness by pelvic floor inpact questionnaire-7( PFIQ–7）,pelvic floor distress inventory-20 （PFDI–20）and pelvic organ prolapse/urinary incontinence sexual questionnaire-12（PISQ–12）. ResultsAll surgical operations were accomplished successfully. No patient required blood transfusion and no rectum，bladder, urethra, blood vessel and nerve was injuryed. Except one patient experienced postoperative urinary retention, and the remaining patients were able to micturate spontaneously 1~2 days after surgery. The recent postoperative morbidity rate was 1.7% （1/56）.Two patients experienced mesh erosion, the long-term postoperative morbidity rate was 3.5%（2/56）. After one year, the subjective and objective cure rate was 100%. Questionnaire scores showed that the overall postoperative quality of life was improved significantly (t=1669, 1921, P＜005), while quality of sexual life insignificantly (t=0124,P＞005). ConclusionThe total pelvic reconstruction surgery is a safe, small trauma, high rate of anatomical and functional recovery, low rate of the recurrence approach for the repair of severe POP. It is worth further clinical promotion, because of significant improvement of the patient's life quality, a little influence on the sex-life quality and the good recent curative effect and safety.

参考文献/References:

[1] Lu Y X, Wang J, Shen W J, et al. Long-term outcomes of the high vaginal uterosacral ligament suspension in treatment of the severe pelvic organ prolapse ［J］. Zhonghua fu chan ke za zhi, 2013, 48(8): 564-569. ［2］Matsuo T, Miyata Y, Ohba K, et al. Recovery from Life‐threatening pelvic organ prolapse in an 80‐year‐old Japanese Woman:a case report ［J］. Clinical Case Reports, 2014, 2(4): 118-121. ［3］陈远群，任慕兰盆腔器官脱垂发病机制的研究进展 ［J］中国妇幼健康研究，2008，19（5）：507-509. ［4］李艳，郝敏，王志莲，等腹腔镜阴道骶骨固定术与传统修补术治疗POP的疗效比较 ［J］中国妇幼健康研究，2014，25（1）：118-121 ［5］Horch RE, Hohenberger W, Eweida A, et al. A hundred patients with vertical rectus abdominis myocutaneous (VRAM) flap for pelvic reconstruction after total pelvic exenteration ［J］. Int J Colorectal Dis, 2014, 29(7): 813-823. ［6］Utomo E, Blok BF, Steensma AB, et al. Validation of the pelvic floor distress inventory (PFDI-20) and pelvic floor impact questionnaire (PFIQ-7) in a Dutch population ［J］. Int Urogynecol J, 2014, 25(4): 531-544. ［7］Celik DB, Beji NK, Yalcin O. Turkish adaptation of the short form of the pelvic organ prolapse/urinary incontinence sexual function questionnaire (PISQ-12): A validation and reliability study ［J］. Neurourol Urodyn, 2013, 32(8): 1068-1073. ［8］Espua-Pons M, Fillol M, Pascual MA, et al. Pelvic floor symptoms and severity of pelvic organ prolapse in women seeking care for pelvic floor problems ［J］. Eur J Obstet Gynecol Reprod Biol, 2014, 177(1): 141-145. ［9］Nygaard I, Brubaker L, Zyczynski HM, et al. Long-term Outcomes Following Abdominal Sacrocolpopexy for Pelvic Organ Prolapse ［J］. JAMA, 2013, 309(19): 2016-2024. ［10］党云，龙丽霞，韩岚，等改良式全盆底悬吊术在女性盆腔器官脱垂中的临床应用 ［J］中国妇幼健康研究，2013，24（1）：82-85 ［11］张云，周宁阴道半封闭术治疗老年严重盆腔器官脱垂临床分析 ［J］中国妇幼健康研究，2013，24（5）：773-775 ［12］Bortolini MA, Rizk D. Genetics of pelvic organ prolapse: reply ［J］. Int Urogynecol J, 2012, 23(4): 511-512. ［13］CHEN J, ZHU L, LANG J-h, et al. Prospective study on total pelvic Reconstruction surgery with Prosima in the treatment of pelvic organ prolapse stage III ［J］. Zhonghua Fu Chan Ke Za Zhi, 2012, 47(9): 664-668. ［14］Murphy AM, Tunitsky-Bitton E, Krlin RM, et al. Utility of postoperative laboratory studies after female pelvic reconstructive surgery ［J］. Am J Obstet Gynecol, 2013, 209(4): e1-e5. ［15］Teleman P, Stenzelius K, Iorizzo L, et al. Validation of the Swedish short forms of the Pelvic Floor Impact Questionnaire (PFIQ-7), Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) ［J］. Acta Obstet Gynecol Scand, 2011, 90(5): 483-487.

相似文献/References:

[1]杨琳,张金玲,张立杰,等.Prolift盆底重建术治疗重度盆腔器官脱垂患者 预后影响因素分析[J].中国计划生育和妇产科,2017,(2):46.
　YANG Lin,ZHANG Jin-ling,ZHANG Li-jie,et al.Prognostic factors of patients with severe pelvic organ prolapse by prolift pelvic reconstruction[J].Chinese Journal of Family Planning & Gynecotokology,2017,(2):46.

备注/Memo

备注/Memo:
十堰市科技局科研项目（项目编号:ZD2011009）
更新日期/Last Update: 2017-02-25