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目的评价特定部位自体组织盆底修补术和Perigee系统治疗重度盆腔脏器脱垂(POP)的临床疗效及安全性。方法 100例诊断为子宫或膀胱脱垂Ⅲ度及以上患者分别采用Perigee盆底重建术(A组,50例)和特定部位自体组织盆底修补术(B组,50例)。手术前后采用POP定量分期(POP-Q)、盆底功能障碍问卷(PFDI-20)和性生活质量问卷(PISQ-12)分析疗效和相关并发症发生情况。结果完成随访91例,中位随访时间为22个月。两种方法均是治疗重度POP的安全有效术式,主观治愈率均为100%;A组客观治愈率93.5%,B组88.9%(P>0.05)。两组在手术时间、术中出血量、术后PFDI-20和PISQ-12评分等方面无统计学差异(P>0.05)。A、B组术后各有2例新发压力性尿失禁;A组网片暴露1例,阴道挛缩1例。结论两种方法均是治疗重度POP的安全有效术式;A组增加网片相关并发症。
Objective To evaluate the clinical efficacy and safety of pelvic floor repair with autologous tissue and Perigee system in the treatment of severe pelvic organ prolapse (POP). Methods Perigee pelvic floor reconstruction (A group, 50 cases) and pelvic autopsies (B group, 50 cases) were performed in 100 cases diagnosed as uterine or bladder prolapse Ⅲ degree and above. Preoperative and postoperative POP-Q (POP-Q), pelvic floor dysfunction questionnaire (PFDI-20) and sexual life quality questionnaire (PISQ-12) were used to analyze the curative effect and related complications. Results 91 cases were followed up, the median follow-up time was 22 months. Both methods were safe and effective for the treatment of severe POP, and the subjective cure rate was 100%. The objective cure rate in group A was 93.5% and in group B 88.9% (P> 0.05). There was no significant difference in the operation time, intraoperative blood loss, postoperative PFDI-20 and PISQ-12 score between the two groups (P> 0.05). There were 2 cases of new stress urinary incontinence in group A and group B, 1 case of mesh exposure in group A and 1 case of vaginal contracture. Conclusions Both of the two methods are safe and effective procedures for the treatment of severe POP. In group A, mesh-related complications are increased.