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目的探讨Avaulta系统盆底重建术的临床疗效及对患者生活质量的影响。方法回顾性分析2012年7月至2013年5月因重度盆腔器官脱垂行Avaulta盆底重建术83例患者的临床资料,通过比较患者术前、术后POP-Q分期、盆底功能障碍影响问卷(PFDI-20),评价Avaulta系统盆底重建术的解剖疗效与功能疗效。结果 83例患者中,3例术后失访,80例纳入研究,其中11例患者有全子宫切除术史。56例患者行前后路Avaulta,17例行单纯前路Avaulta,7例行单纯后路Avaulta,42例保留子宫,27例同时行阴式子宫切除术,中位手术时间100 min(80~150 min),中位出血量150 m(l 100~280 m1)。术中膀胱、直肠损伤各1例,术后随访24~34个月,中位随访27个月,无Ⅱ度及以上脱垂。与术前PFDI-20评分比较,患者术后生活质量明显改善(P<0.05)。结论 Avaulta盆底重建术治疗重度盆腔器官脱垂,微创,安全性好,并发症少,近中期效果良好,远期效果有待进一步观察。
Objective To investigate the clinical efficacy of Avaulta system pelvic floor reconstruction and its impact on the quality of life of patients. Methods The clinical data of 83 patients with Avaase pelvic floor reconstruction who underwent severe pelvic organ prolapse from July 2012 to May 2013 were analyzed retrospectively. By comparing the preoperative and postoperative POP-Q staging and pelvic floor dysfunction Questionnaire (PFDI-20) to evaluate the anatomic and functional outcomes of the Avaulta system pelvic floor reconstruction. Results Of the 83 patients, 3 were lost to follow-up and 80 were included in the study. Eleven patients underwent hysterectomy. Fifty-six patients underwent Avaulta’s anterior and posterior approaches, 17 were treated with avalanche alone, and 7 were treated with Avaulta alone. Forty-two retained the uterus and 27 underwent vaginal hysterectomy at a median time of 100 min (80-150 min ), The median amount of bleeding 150 m (l 100 ~ 280 m1). Intraoperative bladder and rectal injury in 1 case, followed up for 24 to 34 months, the median follow-up of 27 months, no grade II and above prolapse. Compared with the preoperative PFDI-20 score, patients’ postoperative quality of life improved significantly (P <0.05). Conclusions The Avavent pelvic floor reconstruction is an effective method for the treatment of severe pelvic organ prolapse, minimally invasive, good safety, few complications, good near-mid-term results and long-term efficacy.