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目的探讨全盆底重建术治疗女性重度盆腔器官脱垂的近期疗效及安全性。方法回顾性分析湖北省十堰市太和医院2009年12月至2013年12月接受全盆底重建术治疗的重度盆腔器官脱垂56例患者的临床资料,术后定期随访,通过盆腔器官脱垂定量检查法(pelvic organ prolapse quantitation,POP–Q)分期评价解剖疗效,盆底功能影响问卷-简表7(pelvic floor impact questionnaire-7,PFIQ–7)、盆底功能障碍问卷-20(pelvic floor distress inventory-20,PFDI–20)和POP–尿失禁性生活问卷–12(pelvic organ prolapse/urinary incontinence sexual questionnaire-12,PISQ–12)三种生活质量和性生活问卷评价功能疗效,从而分析全盆底重建术的近期疗效及安全性。结果手术均进行顺利,术中术后均无输血,无直肠、膀胱、尿道、血管及神经等损伤。除1例术后尿潴留外,其余均1~2 d恢复自主排尿,近期并发症为1.7%(1/56)。2例网片侵蚀,远期并发症为3.5%(2/56)。术后1年主、客观治愈率均为100%。PFIQ–7和PFDI–20评分显示术后生活质量较术前显著提高(t分别=16.69、19.21,P=0.000),而性生活质量改善不大(t=0.124,P=0.613)。结论全盆底重建术用于纠正重度盆腔器官脱垂,手术安全、创伤小、解剖和功能恢复率高,复发率低,能显著改善患者的生活质量,对性生活质量影响不大,近期疗效及安全性肯定,值得临床上进一步推广。
Objective To investigate the short-term efficacy and safety of pelvic floor reconstruction in the treatment of severe pelvic organ prolapse in women. Methods The clinical data of 56 patients with severe pelvic organ prolapse who underwent total pelvic floor reconstruction from December 2009 to December 2013 in Taihe Hospital of Shiyan City, Hubei Province were retrospectively analyzed. After pelvic organ prolapse The pelvic floor impact questionnaire-7 (PFIQ-7), pelvic floor questionnaire-20 distress inventory-20, PFDI-20) and the POP-12 questionnaire (PISQ-12) Therapeutic efficacy and safety of pelvic floor reconstruction. Results The operation was carried out smoothly. No intraoperative blood transfusion, no rectum, bladder, urethra, blood vessels and nerves were found. In addition to one case of postoperative urinary retention, the rest were 1 ~ 2 d to restore spontaneous urination, the recent complication was 1.7% (1/56). Two cases of mesh erosion, long-term complications were 3.5% (2/56). One year after surgery, the objective cure rate was 100%. PFIQ-7 and PFDI-20 scores showed a significant improvement in postoperative quality of life (t = 16.69, 19.21, P = 0.000, respectively) and no significant improvement in sexual quality (t = 0.124, P = 0.613). Conclusions Total pelvic floor reconstruction is used to correct severe pelvic organ prolapse. It has the advantages of safe operation, small trauma, high rate of anatomic and functional recovery, low recurrence rate, significant improvement of patients’ quality of life, little impact on sexual life, and short-term curative effect And the safety of certain, it is worth further clinical promotion.