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目的探讨Prolift全盆悬吊术和经阴道子宫切除+阴道前后壁修补术2种手术方式治疗盆腔脏器脱垂的临床效果差异。方法 90例盆腔脏器脱垂患者,采用Prolift全盆悬吊术治疗30例为观察组,60例采用经阴道子宫切除+阴道前后壁修补术治疗者为对照组。比较2组手术时间、术中出血量、术后保留导尿时间、住院时间、术后阴道长度及疗效。结果观察组手术时间[(69.5±11.3)min]较对照组[(124.7±14.0)min]短,术中出血量[(58.7±18.0)mL]较对照组[(133.5±26.4)mL)]少,差异有统计学意义(P<0.05);观察组术后保留导尿时间[(5.3±1.2)d]、住院时间[(8.2±1.7)d]与对照组[(5.7±1.5)、(8.5±2.0)d]比较差异无统计学意义(P>0.05);术后观察组阴道长度[(6.39±0.45)cm]与术前[(6.42±0.47)cm]比较差异无统计学意义(P>0.05),大于对照组术后[(5.86±0.55)cm](P<0.05);随访12个月,观察组治愈率(93.33%)高于对照组(73.33%),差异有统计学意义(P<0.05);观察组术后并发症发生率(10.0%)与对照组(15.0%)比较差异无统计学意义(P>0.05)。结论盆腔脏器脱垂采用Prolift全盆悬吊术重建盆底功能,其疗效优于经阴道子宫切除+阴道前后壁修补术。
Objective To investigate the clinical effects of Prolift pelvic suspension and vaginal hysterectomy + vaginal anterior and posterior wall repair of two kinds of surgical treatment of pelvic organ prolapse. Methods 90 patients with pelvic organ prolapse were treated with Prolift pelvic suspension in 30 patients and 60 patients treated by vaginal hysterectomy plus vaginal anterior and posterior wall repair as control group. The operation time, intraoperative blood loss, postoperative catheterization time, hospital stay, postoperative vaginal length and curative effect were compared. Results The operative time in the observation group was (69.5 ± 11.3) min shorter than that in the control group (124.7 ± 14.0 min) and the intraoperative blood loss (58.7 ± 18.0 mL) was significantly higher than that in the control group (133.5 ± 26.4 mL) (5.3 ± 1.2) d, length of hospital stay [(8.2 ± 1.7) d] and control group [(5.7 ± 1.5), respectively], and the difference was statistically significant (P0.05) (8.5 ± 2.0) d] (P> 0.05). There was no significant difference in the vaginal length between the observation group [(6.39 ± 0.45) cm] and [6.42 ± 0.47 cm] before operation (P> 0.05), which was significantly higher than that of the control group [(5.86 ± 0.55) cm] (P <0.05). After 12 months of follow-up, the cure rate of the observation group was 93.33% higher than that of the control group (73.33% (P <0.05). The incidence of postoperative complications in the observation group (10.0%) was not significantly different from that in the control group (15.0%) (P> 0.05). Conclusions Pelvic organ prolapse using Prolift pelvic suspension reconstruction of pelvic floor function, the effect is better than transvaginal hysterectomy + vaginal anterior and posterior wall repair.