中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2010, Vol. 39 ›› Issue (2): 150–.

• 临床医学 • 上一篇    下一篇

老年女性盆底功能障碍疾病治疗的临床探讨

赵颖; 夏志军; 胡清; 李宝香; 陈旭   

  1. 中国医科大学研究生院; 中国医科大学附属盛京医院妇产科
  • 出版日期:2010-02-27 发布日期:2013-06-07
  • 通讯作者: 夏志军 E-mail:xiazhijunhosp2@sina.com

Efficacy of Total Pelvic Floor Reconstruction with Pesh Match for Presby-pelvic Floor Dysfunction

  • Online:2010-02-27 Published:2013-06-07

摘要:

目的比较应用补片的全盆底重建术与传统阴式全子宫切除及阴道前后壁修补在老年性盆底功能障碍患者治疗中的疗效差异。方法随机选取我院2007年9月至2009年2月间的92例老年盆底功能障碍患者,70例(全盆底重建组)采用补片的全盆底重建术,其中合并压力性尿失禁12例,4例同时行经闭孔阴道无张力尿道中段悬吊带手术(TVT-O);22例(对照组)应用传统阴式全子宫切除及阴道前后壁修补,合并压力性尿失禁3例。结果术后3~18个月门诊复查,全盆底重建组未见术后复发,盆腔器官脱垂(POP)评分法测定均为0度,治愈率达100%;对照组术后复发7例,复发病例均为阴道前壁膨出,其中5例术后POP评分Ⅱ度,2例POP评分Ⅲ度,即阴道穹隆完全膨出,治愈率68%;对于同时合并压力性尿失禁患者,盆底重建组中,通过应用TVT-O或前路补片提升的办法,尿失禁均治愈,对照组中患者症状无明显改善,2例症状加重。结论应用替代材料的全盆底重建术在治疗老年盆底功能障碍中疗效确切。

关键词: 盆底功能障碍, 补片, 全盆底重建术

Abstract:

Objective To compare the efficacy of total pelvic floor
      reconstruction with mesh patch and vaginal hysterectomy with anterior and
      posterior vaginal wall repair for presby-pelvic floor dysfunction
      patients.Methods We randomly chose 92 pelvic floor dysfunction inpatients
      of our hospital from September 2007 to February 2009 and divided them into
      2 groups:total pelvic floor reconstruction group(n =70) underwent total
      pelvic floor reconstruction with mesh patch12 patients of this group
      complicated with stress incontinence,4 patients received tension free
      vaginal tape-obturator(TVT-O)simultaneously;control group(n =22)received
      vaginal hysterectomy with anterior and posterior vaginal wall repair(3
      patients of this group complicated with stress incontinence).A follow-up
      for 3 to 18 months after the surgery were taken in all the
      patients.Results In total pelvic floor reconstruction group,no recidivate
      case was found and the POP scores and cure rate were 0 and 100%
      respectively.In control group,there were 7 recidivate cases,all of
      who were primary vagina anterior wall bulge patients.The cure rate of
      control group was 68%;For the patients complicated with stress
      incontinence,they were all cured by TVT-O or by ascending the front patch
      in total pelvic floor reconstruction group,but 1 case was as before
      operation and 2 cases were even worse in control group.Conclusion Total
      pelvic floor reconstruction with vicarious materials had a definite
      efficacy for presby-pelvic floor dysfunction.

Key words: pelvic floor dysfunction, mesh patch, total pelvic floor reconstruction

[1] 李君. 腹腔镜经腹膜前补片植入术治疗双侧腹股沟疝患者的 围术期护理体会[J]. 中国医科大学学报, 2017, 46(5): 470-471.
[2] 张玉新,夏志军,许海楠,赵颖. 女性盆底功能障碍疾病的临床诊断模式探讨[J]. 中国医科大学学报, 2012, 41(7): 659-660.
[3] 程大丽, 穆庆, 夏志军. 女性压力性尿失禁患者盆底生物反馈治疗36例临床分析[J]. 中国医科大学学报, 2009, 38(10): 778-.
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