国际妇产科学杂志
國際婦產科學雜誌
국제부산과학잡지
JOURNAL OF INTERNATIONAL OBSTETRICS AND GYNECOLOGY
2015年
4期
437-440
,共4页
盆腔脏器脱垂%子宫切除术,阴道式%对照组%治疗结果%生活质量
盆腔髒器脫垂%子宮切除術,陰道式%對照組%治療結果%生活質量
분강장기탈수%자궁절제술,음도식%대조조%치료결과%생활질량
Pelvic organ prolapse%Hysterectomy,transvaginal%Control groups%Treatment outcome%Quality of life
目的：比较全盆底重建术与传统阴式修补术治疗老年女性盆腔器官脱垂（POP）的临床效果以及对远期生活质量的影响。方法：选择2008年2月—2009年2月在中国人民解放军白求恩国际和平医院妇产科进行手术治疗且完成随访的盆腔器官脱垂患者60例，年龄≥55岁，均为绝经后妇女，POP-Q分期为Ⅲ～Ⅳ期。采用网片进行全盆底重建术的30例患者为观察组，采用传统的经阴道全子宫切除术加阴道前后壁修补术的30例患者为对照组。术后5年内定期门诊随访，以POP-Q判断术后疗效，盆底不适调查表简表（PFDI-20）评价术后患者生活质量。结果：观察组和对照组的手术时间[（107.83±13.00）min vs.（127.50±13.25）min]，术中出血量[（194.67±21.13）mL vs.（220.67±28.15）mL]，住院总费用[（32488.38±3408.43）元vs.（13811.41±2634.89）元]相比，差异均有统计学意义（P＜0.05）。术后POP-Q重新评分，至术后5年，观察组有1例复发至Ⅱ度，对照组5例复发。2组患者术后1，6个月的PFDI-20评分相比差异无统计学意义（P＞0.05），而观察组术后1，2，5年的PFDI-20评分低于对照组，差异有统计学意义（均P＜0.05）。结论：与传统经阴道子宫切除术加阴道前后壁修补术相比，全盆底重建术术后复发率低，生活质量改善明显，但费用较高。
目的：比較全盆底重建術與傳統陰式脩補術治療老年女性盆腔器官脫垂（POP）的臨床效果以及對遠期生活質量的影響。方法：選擇2008年2月—2009年2月在中國人民解放軍白求恩國際和平醫院婦產科進行手術治療且完成隨訪的盆腔器官脫垂患者60例，年齡≥55歲，均為絕經後婦女，POP-Q分期為Ⅲ～Ⅳ期。採用網片進行全盆底重建術的30例患者為觀察組，採用傳統的經陰道全子宮切除術加陰道前後壁脩補術的30例患者為對照組。術後5年內定期門診隨訪，以POP-Q判斷術後療效，盆底不適調查錶簡錶（PFDI-20）評價術後患者生活質量。結果：觀察組和對照組的手術時間[（107.83±13.00）min vs.（127.50±13.25）min]，術中齣血量[（194.67±21.13）mL vs.（220.67±28.15）mL]，住院總費用[（32488.38±3408.43）元vs.（13811.41±2634.89）元]相比，差異均有統計學意義（P＜0.05）。術後POP-Q重新評分，至術後5年，觀察組有1例複髮至Ⅱ度，對照組5例複髮。2組患者術後1，6箇月的PFDI-20評分相比差異無統計學意義（P＞0.05），而觀察組術後1，2，5年的PFDI-20評分低于對照組，差異有統計學意義（均P＜0.05）。結論：與傳統經陰道子宮切除術加陰道前後壁脩補術相比，全盆底重建術術後複髮率低，生活質量改善明顯，但費用較高。
목적：비교전분저중건술여전통음식수보술치료노년녀성분강기관탈수（POP）적림상효과이급대원기생활질량적영향。방법：선택2008년2월—2009년2월재중국인민해방군백구은국제화평의원부산과진행수술치료차완성수방적분강기관탈수환자60례，년령≥55세，균위절경후부녀，POP-Q분기위Ⅲ～Ⅳ기。채용망편진행전분저중건술적30례환자위관찰조，채용전통적경음도전자궁절제술가음도전후벽수보술적30례환자위대조조。술후5년내정기문진수방，이POP-Q판단술후료효，분저불괄조사표간표（PFDI-20）평개술후환자생활질량。결과：관찰조화대조조적수술시간[（107.83±13.00）min vs.（127.50±13.25）min]，술중출혈량[（194.67±21.13）mL vs.（220.67±28.15）mL]，주원총비용[（32488.38±3408.43）원vs.（13811.41±2634.89）원]상비，차이균유통계학의의（P＜0.05）。술후POP-Q중신평분，지술후5년，관찰조유1례복발지Ⅱ도，대조조5례복발。2조환자술후1，6개월적PFDI-20평분상비차이무통계학의의（P＞0.05），이관찰조술후1，2，5년적PFDI-20평분저우대조조，차이유통계학의의（균P＜0.05）。결론：여전통경음도자궁절제술가음도전후벽수보술상비，전분저중건술술후복발솔저，생활질량개선명현，단비용교고。
Objective:To compare the clinical effects and long-period life quality between total pelvic floor reconstruction and transvaginal hysterectomy with vaginal anterior and posterior wall repair in older women with pelvic organ prolapse (POP). Methods:From February 2008 to February 2009,sixty POP patients were reviewed in our study whose age was over 55 years old. They were all postmenopausal women and POP-Q were stageⅢ-Ⅳ. The study group contain of 30 cases used the mesh of total pelvic floor reconstruction,and the control group adopted conventional surgical transvaginal hysterectomy with vaginal anterior and posterior wall repair in 30 patients. We regular followed up all women last 5 years in outpatient by POP-Q and questionnaire (PFDI-20) which were used to evaluate the life quality. Results:In the study group and the control group,operation time [(107.83±13.00)min vs. (127.50±13.25)min],bleeding [(194.67±21.13)mL vs. (220.67±28.15)mL],total cost of hospitalization [(32 488.38±3 408.43)￥vs. (13 811.41±2 634.89)￥],had statistical significances (P<0.05). There was 1 case recurrence toⅡstage in the study group and 5 cases in the control group by POP-Q score postoperative 5 years. Postoperative 5 years, PFDI-20 scores in the two groups were compared,there were no statistical significance after 1,6 months opposite. There were statistical significance after 1,2,5 years,the women had lower scores and higher quality of life in the study group. Conclusions:The total pelvic floor reconstruction was lower recurrence rate ,higher quality of life and cost more than the traditional vaginal hysterectomy with vaginal anterior and posterior wall repair in older women with pelvic organ prolapse.
