中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2014年
5期
499-502
,共4页
张斯由%崔颖%申桂华%吕秋波%张毅
張斯由%崔穎%申桂華%呂鞦波%張毅
장사유%최영%신계화%려추파%장의
子宫脱垂%生物相容性材料
子宮脫垂%生物相容性材料
자궁탈수%생물상용성재료
Uterine prolapse%Biocompatible materials
目的 探讨生物补片用于阴道前壁膨出修补术老年妇女的有效性和安全性. 方法 选取2010年1月至2013年10月于我院妇科行前盆腔器官重建手术患者68例,根据患者意愿分为采用生物补片修补术治疗阴道前壁膨出患者36例(生物补片组)和采用单纯改良阴道旁修补术治疗阴道前壁膨出患者32例(单纯改良组),比较两组患者手术完成情况及其安全指标,并于术后1、3、6、12、24个月定期随访,对手术效果进行评价. 结果 所有患者阴道前壁膨出修补术均获成功,无手术并发症及死亡.生物补片组患者手术时间、术中出血量、术后保留尿管时间和术后住院时间分别为(88.1±18.3)min、(140.3±77.6) ml、(5.30±1.79)d、(5.53±2.00)d,与单纯改良组患者(88.0±17.4)min、(141.3±64.9) ml、(4.90±2.34)d、(5.50±2.08)d比较差异均无统计学意义(t=0.01、0.05、0.64、0.06,P=0.996、0.957、0.525、0.954).按国际尿控协会采纳的盆腔器官脱垂定量系统(POP-Q)分期,36例生物补片修补术后患者未见复发;32例单纯改良修补术后患者复发4例(12.5％),其中3例为Ⅱ期,1例为Ⅲ期,两组复发率差异有统计学意义(x2=4.79,P＜0.05). 结论 生物源性补片用于阴道前壁及膀胱膨出修补术效果满意,方法简单且并发症少,与单纯改良阴道旁修补术比较不增加手术时间和术中出血量,且术后未见补片侵蚀及暴露发生.
目的 探討生物補片用于陰道前壁膨齣脩補術老年婦女的有效性和安全性. 方法 選取2010年1月至2013年10月于我院婦科行前盆腔器官重建手術患者68例,根據患者意願分為採用生物補片脩補術治療陰道前壁膨齣患者36例(生物補片組)和採用單純改良陰道徬脩補術治療陰道前壁膨齣患者32例(單純改良組),比較兩組患者手術完成情況及其安全指標,併于術後1、3、6、12、24箇月定期隨訪,對手術效果進行評價. 結果 所有患者陰道前壁膨齣脩補術均穫成功,無手術併髮癥及死亡.生物補片組患者手術時間、術中齣血量、術後保留尿管時間和術後住院時間分彆為(88.1±18.3)min、(140.3±77.6) ml、(5.30±1.79)d、(5.53±2.00)d,與單純改良組患者(88.0±17.4)min、(141.3±64.9) ml、(4.90±2.34)d、(5.50±2.08)d比較差異均無統計學意義(t=0.01、0.05、0.64、0.06,P=0.996、0.957、0.525、0.954).按國際尿控協會採納的盆腔器官脫垂定量繫統(POP-Q)分期,36例生物補片脩補術後患者未見複髮;32例單純改良脩補術後患者複髮4例(12.5％),其中3例為Ⅱ期,1例為Ⅲ期,兩組複髮率差異有統計學意義(x2=4.79,P＜0.05). 結論 生物源性補片用于陰道前壁及膀胱膨齣脩補術效果滿意,方法簡單且併髮癥少,與單純改良陰道徬脩補術比較不增加手術時間和術中齣血量,且術後未見補片侵蝕及暴露髮生.
목적 탐토생물보편용우음도전벽팽출수보술노년부녀적유효성화안전성. 방법 선취2010년1월지2013년10월우아원부과행전분강기관중건수술환자68례,근거환자의원분위채용생물보편수보술치료음도전벽팽출환자36례(생물보편조)화채용단순개량음도방수보술치료음도전벽팽출환자32례(단순개량조),비교량조환자수술완성정황급기안전지표,병우술후1、3、6、12、24개월정기수방,대수술효과진행평개. 결과 소유환자음도전벽팽출수보술균획성공,무수술병발증급사망.생물보편조환자수술시간、술중출혈량、술후보류뇨관시간화술후주원시간분별위(88.1±18.3)min、(140.3±77.6) ml、(5.30±1.79)d、(5.53±2.00)d,여단순개량조환자(88.0±17.4)min、(141.3±64.9) ml、(4.90±2.34)d、(5.50±2.08)d비교차이균무통계학의의(t=0.01、0.05、0.64、0.06,P=0.996、0.957、0.525、0.954).안국제뇨공협회채납적분강기관탈수정량계통(POP-Q)분기,36례생물보편수보술후환자미견복발;32례단순개량수보술후환자복발4례(12.5％),기중3례위Ⅱ기,1례위Ⅲ기,량조복발솔차이유통계학의의(x2=4.79,P＜0.05). 결론 생물원성보편용우음도전벽급방광팽출수보술효과만의,방법간단차병발증소,여단순개량음도방수보술비교불증가수술시간화술중출혈량,차술후미견보편침식급폭로발생.
Objective To explore the efficacy and safety of biological mesh during female anterior pelvic organ reconstruction.Methods The 68 consecutive women with symptomatic anterior vaginal wall prolapse in Beijing hospital from January 2010 to June 2013 were divided into two groups:6 cases underwent anterior vaginal wall repair with biological mesh,and 32 cases underwent vaginal approach to paravaginal repair.Preoperative and postoperative pelvic evaluations were performed with the POP-Q system.Patients were followed up at 1,3,6,12,24 months after operation.Objective cure was defined if the lateral sulci of the anterior vaginal walls were at grade 0 and firmly apposed to the lateral pelvic sidewalls.Results Among 68 patients,38 had grade Ⅲ and 30 had grade Ⅳ anterior vaginal wall prolapse.In all patients the anterior vaginal repair was performed successfully.The indexes of operation time,amount of bleeding,the postoperative retention time of catheter and hospital stay had no difference between biological mesh and vaginal approach groups [(88.1±18.3)min vs.(88.0±17.4)min,(140.3±77.6) ml vs.(141.3±64.9) ml,(5.30±1.79) d vs.(4.90±2.34) d,(5.53±2.00)d vs.(5.50±2.08)d,t=0.01,0.05,0.64,0.06,respectively,all P＞0.05].No complication happened during and after operation.No one relapsed in biological mesh group and 4 cases relapsed in paravaginal repair group.The relapse rate between two groups is statistically different(x2 =4.79,P＜0.05).Conclusions The anterior vaginal repair with biological mesh is effective during female anterior pelvic organ reconstruction,but the long-term outcome of biological mesh in pelvic floor construction needs further study.
