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改良全盆底重建手术治疗女性盆腔器官脱垂35例疗效观察 被引量:5

Modified total pelvic floor reconstruction in treatment of severe organ prolapse in 35 patients
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摘要 目的评价改良盆底重建术治疗盆腔脏器脱垂的临床效果。方法盆腔脏器脱垂定量(POP-Q)分度为Ⅲ~Ⅳ度35例患者行改良盆底重建术,观察手术时间、术中出血量、住院时间等围手术期指标,以POP-Q分度为客观疗效评价指标,以临床症状消失为主观治愈指标。术后定期随访,观察疗效。结果手术平均时间(55士20.2)min、术中平均出血(100±40.2)ml,术后住院平均(4.5±1.5)d,术后随访3~18个月、中位随访时间6个月,客观治愈率94%(33/35),主观有效率91%(32/35)。术后仅1例发生网片侵蚀,3例发生排尿困难,2例发生性交痛,2例发生急迫性尿失禁。结论改良盆底重建术是治疗盆腔脏器脱垂的有效术式,保留子宫同时加强盆底组织,手术简单、安全、微创、经济,远期疗效有待进一步观察。 Objective: To evaluate the effect of modified pelvic floor reconstruction on pelvic organ prolapse. Methods: Modified total pelvic floor reconstruction was performed, from Sep. 2007 to sept. 2009 in the hospital, on 35 patients with pelvic organ prolapse at stage of Ⅲ-Ⅳ, classified by the international pelvic organ prolapse staging system (POP-Q). Operation time, blood loss during operation and length of hospital stay were recorded. Patients were followed up at 3, 6 and 12 months postoperation. Pelvic status and organ prolapse were evaluated with POP-Q system, and symptoms reported by patients. Results: The operation was successfully conducted in all patients, without any operation-related injure to internal organs. The mean operation time was 55±20.2 minutes, mean blood loss was 100±40.2 ml, and mean hospital stay was 4.5±1.5 days. The median follow-up was 6 months (3-18 months). The pelvic organ prolapse, evaluated by POP-Q system, was totally relived in 33 (94.3%) patients and partially relived in the other two. One mesh erosion was observed 5 weeks after operation, and mended. Three patients reported dysuria, 2 experienced stress urinary incontinence and 2 complained dyspareunia, but recovered over time. Sexual activities were improved in all but two patients. No severe complications were found in any patients. Conclusions: Modified pelvic floor reconstruction is a simple, safe, effective, economic and micro-in- vasive method for pelvic organ prolapse. Its long-term effect needs to be followed up.
作者 辛峰 朱兰
出处 《生殖医学杂志》 CAS 2010年第5期411-414,共4页 Journal of Reproductive Medicine
关键词 盆腔脏器脱垂 盆底重建 治疗效果 并发症 Pelvic organ prolapse Pelvic floor reconstruction Therapeutic effect Complications
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