CAJ | 학술논문

目的：探讨盆腔器官脱垂（POP）患者治疗前预期目标，分析治疗后预期目标达到程度、新发症状与治疗后满意度的相关性。方法收集2013年1月1日至12月31日就诊于北京大学第三医院有症状、要求治疗的75例POP患者的临床资料。前瞻性调查患者的治疗前预期目标（即要求解决的最困扰的症状）；按治疗方式分为手术组和子宫托组，随访治疗后的满意度评分、新发症状，采用患者整体印象改善评分（PGI-I）评估预期目标达到程度，比较两组患者治疗后PGI-I评分、满意度、新发症状的差异并分析PGI-I评分、新发症状与满意度的相关性。结果75例POP患者中，手术组47例，子宫托组28例。治疗前预期目标前3位分别为解决走路摩擦（25%，19/75）、排尿困难（23%，17/75）、阴道脱出物（19%，14/75）。随访率93%（70/75），随访时间（5±4）个月。手术组及子宫托组患者治疗后的满意度评分分别为（4.9±0.4）、（4.0±1.3）分，两组比较，差异有统计学意义（P<0.01）。手术组及子宫托组患者的PGI-I评分分别为（6.7±0.6）、（6.6±0.9）分，两组比较，差异无统计学意义（P=0.886）。新发症状前3位分别为阴道分泌物增多、尿失禁、排尿困难。PGI-I评分与治疗后满意度有相关性（P=0.021），有无新发症状与治疗后满意度有相关性（P=0.001）。结论 POP患者中预期目标达到程度高及新发症状少者治疗后满意度高。
목적：탐토분강기관탈수（POP）환자치료전예기목표，분석치료후예기목표체도정도、신발증상여치료후만의도적상관성。방법수집2013년1월1일지12월31일취진우북경대학제삼의원유증상、요구치료적75례POP환자적림상자료。전첨성조사환자적치료전예기목표（즉요구해결적최곤우적증상）；안치료방식분위수술조화자궁탁조，수방치료후적만의도평분、신발증상，채용환자정체인상개선평분（PGI-I）평고예기목표체도정도，비교량조환자치료후PGI-I평분、만의도、신발증상적차이병분석PGI-I평분、신발증상여만의도적상관성。결과75례POP환자중，수술조47례，자궁탁조28례。치료전예기목표전3위분별위해결주로마찰（25%，19/75）、배뇨곤난（23%，17/75）、음도탈출물（19%，14/75）。수방솔93%（70/75），수방시간（5±4）개월。수술조급자궁탁조환자치료후적만의도평분분별위（4.9±0.4）、（4.0±1.3）분，량조비교，차이유통계학의의（P<0.01）。수술조급자궁탁조환자적PGI-I평분분별위（6.7±0.6）、（6.6±0.9）분，량조비교，차이무통계학의의（P=0.886）。신발증상전3위분별위음도분비물증다、뇨실금、배뇨곤난。PGI-I평분여치료후만의도유상관성（P=0.021），유무신발증상여치료후만의도유상관성（P=0.001）。결론 POP환자중예기목표체도정도고급신발증상소자치료후만의도고。
Objective To investigate the relevance between expectations before treatment, new symptoms and satisfaction after treatment of the pelvic organ prolapse (POP) patients. Methods Made a collection of 75 cases of POP patients at Peking University Third Hospital, who were affected by the POP symptoms and came to our clinic for treatment from January to December in 2013. Prospectively investigate the patients′expectations before treatment, which were the most troubling symptoms to be solved. According to treatment we divided the patients into surgery and pessary groups. Two groups were followed up with the degree to achieve the desired goals using patient global impression of improvement (PGI-I), new symptoms and satisfaction after treatment, try to find the relevance between expectations before treatment, new symptoms and satisfaction after treatment. Results There were 47 (63%, 47/75) patients in the surgical group and 28 (37%, 28/75) patients in the pessary group. The top three problems for patients were friction when walking (25%, 19/75), dysuria (23%, 17/75) and the feeling of vaginal prolapse (19%, 14/75). The follow-up rate was of 93% (70/75), follow-up time was (5 ± 4) months. Satisfaction score after treatment of surgical group was higher than that of pessary group [(4.9±0.4) versus (4.0±1.3) scores, P<0.01]. There was no statistically significant difference between two groups of PGI-I score [(6.7±0.6) versus (6.6±0.9) scores, P=0.886]. The top three new symptoms after treatment were increased secretion, urinary incontinence and dysuria. PGI-I and satisfaction scores was relevant (P=0.021). The availability of new symptoms and satisfaction scores was relevant (P=0.001). Conclusion When achieving higher expectations to the treatment and no more new symptoms, the satisfaction score after treatment is higher.