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目的探讨前盆重建术对阴道前壁脱垂患者生活质量的影响。方法选取2012年1月-2013年12月在柳州市工人医院院妇诊断为阴道前壁脱垂(AVWP)患者100例,随机分为研究组和对照组,每组50例。研究组接受前盆重建术治疗,对照组接受阴道前壁修补术治疗。记录所有手术时间和出血情况,有无术中并发症及发生率,分别于手术后3个月、6个月和12个月时随访,手术前后患者填写相关生活质量量表:盆底功能障碍问卷(PFDI-20)、盆底障碍影响简易问卷7(PFIQ-7)及世界卫生组织生存质量测定量表简表(WHOQOL-BREF)。结果研究组患者的手术时间、术中出血量、术后住院时间及留置尿管时间显著低于对照组(P<0.05)。术后随访发现,在3个月、6个月及12个月,研究组治愈率显著高于对照组(P<0.05);两组PFDI-20、PFIQ-7得分显著降低,WHO QOL-BREF得分显著升高(P<0.05);术后6个月及12个月,研究组患者PFDI-20、PFIQ-7得分显著低于对照组,WHO QOL-BREF得分显著高于对照组(P<0.05);术后6个月及12个月,两组患者POP-Q分度比较有显著性差异(P<0.05);本研究中,患者均未发生严重不良并发症,但研究组并发症发生率显著低于对照组。结论前盆重建术治疗AVWP患者,相较于传统手术方式,可显著提高疗效,降低并发症发生率,改善患者生活质量,方法简单,操作容易,不延长手术时间,值得临床推荐。
Objective To investigate the effect of anterior pelvic reconstruction on the quality of life in patients with anterior vaginal wall prolapse. Methods A total of 100 cases of vaginal anterior wall prolapse (AVWP) were selected from January 2012 to December 2013 in Liuzhou Workers Hospital and randomly divided into study group and control group with 50 cases in each group. The study group received anterior pelvic reconstruction and the control group received vaginal anterior wall repair. All operation time and bleeding were recorded. The intraoperative complications and incidence were recorded at 3 months, 6 months and 12 months after surgery. The patients before and after surgery were asked to fill in the relevant quality of life scales: pelvic floor dysfunction Questionnaire (PFDI-20), Simple Impairment of the Pelvic Floor Questionnaire 7 (PFIQ-7) and the WHO Quality of Life Scale (WHOQOL-BREF). Results The operation time, intraoperative blood loss, postoperative hospital stay and indwelling catheter time in study group were significantly lower than those in control group (P <0.05). After 3 months, 6 months and 12 months, the cure rate of the study group was significantly higher than that of the control group (P <0.05). The scores of PFDI-20 and PFIQ-7 in both groups were significantly decreased, and the scores of WHO QOL-BREF The score of PFDI-20 and PFIQ-7 in study group was significantly lower than that in control group at 6 months and 12 months after operation (P <0.05), and the score of WHO QOL-BREF was significantly higher than that in control group (P < 0.05). There was significant difference in POP-Q index between the two groups (P <0.05) at 6 months and 12 months after operation. In this study, no serious adverse complications occurred in the patients. However, the complications of the study group The incidence was significantly lower than the control group. Conclusions Anterior pelvic reconstruction for patients with AVWP can significantly improve the curative effect, reduce the incidence of complications and improve the quality of life of patients with AVWP. The method is simple, easy to operate and does not extend the operation time, which is worthy of clinical recommendation.