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目的:评价传统阴式手术及Prolift TM系统进行全盆底重建术治疗重度盆底器官脱垂的效果,评价其疗效及安全性。方法:回顾性分析2005年1月～2010年1月厦门大学附属第一医院82例患有POP-Q分期Ⅲ期或Ⅳ期的生殖器官脱垂患者,42例施行全盆底重建术(重建组)及40例施行传统手术治疗(阴式子宫切除、阴道前后壁修补以及会阴修补)(传统组)。结果:重建组平均手术时间、术中出血量、术后住院天数分别为(70.75±15.12)min、(98.44±25.02)ml、(5.25±1.23)天,传统组分别为(95.42±16.25)min、(132.60±30.12)ml、(8.34±1.38)天,两组差异均有统计学意义(P<0.05);重建组患者尿管留置时间为(4.85±1.38)天,传统组(5.05±1.4)天,两组比较差异无统计学意义(P>0.05)。重建组术后3个月、6个月及12个月的治愈率分别为97.62%(41/42)、95.24%(40/42)、95.00%(38/40),传统组分别为97.50%(39/40)、92.50%(37/40)、76.92%(30/39),重建组客观治愈率高于传统组,术后3个月及6个月两组间比较差异无统计学意义(P>0.05),1年后两组间比较差异有统计学意义(P<0.05)。结论:Prolifi TM系统全盆底重建术能更好地修补缺陷,恢复盆底结构,短期疗效安全可行,长期疗效有待进一步观察。
OBJECTIVE: To evaluate the effect of traditional vaginal surgery and Prolift TM system for pelvic floor reconstruction in the treatment of severe pelvic organ prolapse and to evaluate its efficacy and safety. Methods: A retrospective analysis of 82 patients with genital prolapse with POP-Q stage Ⅲ or Ⅳ in the First Affiliated Hospital of Xiamen University from January 2005 to January 2010 was performed. 42 cases underwent pelvic floor reconstruction (reconstruction Group) and 40 patients underwent traditional surgery (vaginal hysterectomy, vaginal anterior and posterior wall repair and perineal repair) (traditional group). Results: The mean operative time, intraoperative blood loss and postoperative hospital stay were (70.75 ± 15.12) min, (98.44 ± 25.02) ml and (5.25 ± 1.23) days respectively in the reconstructive group compared with 95.42 ± 16.25 min , (132.60 ± 30.12) ml and (8.34 ± 1.38) days, respectively. There was significant difference between the two groups (P <0.05). The urinary catheter indwelling time was 4.85 ± 1.38 days in the reconstruction group and 5.05 ± 1.4 ) Days, no significant difference between the two groups (P> 0.05). The cure rates of three, six and 12 months postoperatively in the reconstruction group were 97.62% (41/42), 95.24% (40/42) and 95.00% (38/40), respectively, and those in the traditional group were 97.50% (39/40), 92.50% (37/40) and 76.92% (30/39) respectively. The objective cure rate in the reconstruction group was higher than that in the traditional group. There was no significant difference between the two groups after 3 months and 6 months (P> 0.05). After one year, there was significant difference between the two groups (P <0.05). Conclusion: Prolifi TM system pelvic floor reconstruction can better repair defects and restore pelvic floor structure. Short-term curative effect is safe and feasible. Long-term curative effect needs to be further observed.