CAJ | 학술논문

目的探讨改良阴道旁修补术治疗阴道前壁及膀胱膨出的有效性和安全性.方法我院自2007年1月至2009年8月采用改良阴道旁修补术治疗52例阴道前壁及膀胱膨出的患者,其中6例患者既往曾行阴道前壁修补术.术后1、3、6、12、24个月定期随访,对手术效果进行主观及客观评价.客观治愈标准定义为阴道残端位于坐骨棘水平.结果 52例患者盆腔器官脱垂定量系统(POP-Q)分期Ⅱ期30例,Ⅲ期17例,Ⅳ期5例.所有患者改良阴道旁修补术均获成功.手术时间为45～110 min,平均(65±18)min,出血量50～200 ml,平均(95±27)ml,无其他手术并发症.随访3～24个月,平均(10.1±3.1)个月,复发6例(11.5%);其中5例为POP-Q分期Ⅰ期,1例POP-Q分期Ⅲ期.结论改良阴道旁修补术在盆底重建中短期治疗效果稳定,较应用补片手术方法简单,并发症少.
목적 탐토개량음도방수보술치료음도전벽급방광팽출적유효성화안전성.방법 아원자2007년1월지2009년8월채용개량음도방수보술치료52례음도전벽급방광팽출적환자,기중6례환자기왕증행음도전벽수보술.술후1、3、6、12、24개월정기수방,대수술효과진행주관급객관평개.객관치유표준정의위음도잔단위우좌골극수평.결과 52례환자분강기관탈수정량계통(POP-Q)분기Ⅱ기30례,Ⅲ기17례,Ⅳ기5례.소유환자개량음도방수보술균획성공.수술시간위45～110 min,평균(65±18)min,출혈량50～200 ml,평균(95±27)ml,무기타수술병발증.수방3～24개월,평균(10.1±3.1)개월,복발6례(11.5%);기중5례위POP-Q분기Ⅰ기,1례POP-Q분기Ⅲ기.결론 개량음도방수보술재분저중건중단기치료효과은정,교응용보편수술방법간단,병발증소.
Objective To explore the efficacy and safety of modified vaginal paravaginal repair (VPVR) in treatment of symptomatic paravaginal defect cystocele(PDCC). Methods This study was an observational case series of 52 consecutive women in Beijing hospital from January 2007 to August 2009, with symptomatic paravaginal defect cystocele. Among them, 6 patients had anterior wall colporrhaphy. Preoperative and postoperative pelvic evaluations were performed with the POP-Q system. All the cases underwent vaginal approach to paravaginal repair, 49 cases underwent vaginal hysterectomy simultaneously. Patients were followed up for 1 to 24 months. Criteria for objective cure were defined as the anterior vaginal walls at grade 0 and firmly apposing to the lateral pelvic sidewalls.Results Of the 52 patients, 30 had grade Ⅱ , 17 had grade Ⅲ, and 5 had grade Ⅳ paravaginal defect cystocele. In all patients the VPVR was performed successfully. No complication happened during and after operation. The average operation time was (65 ±18) min (45-110 min) and estimated blood loss was (95 ± 27) ml (50-200 ml). Patients were followed up postoperatively for 3 to 24months, with a mean of (10. 1±3.1) months. The PDCC recurred in 6 cases, 5 patients had grade Ⅰcystocele and 1 had grade Ⅲ cystocele. Conclusions The vaginal approach to the correction of paravaginal defect cystocele is highly effective in our population.