摘要
目的 对因盆腔器官脱垂 (pelvicorganprolapse ,POP)进行手术治疗的患者进行随访 ,了解术后复发率 ,并分析复发相关因素。方法 选择 1999年 7月～ 2 0 0 4年 2月因POP在我院住院的手术患者 ,进行问卷调查和妇科检查。根据妇科检查结果分为复发组、未复发组 ,比较两组患者的临床特征、手术情况和术后情况。数据通过SPSS 11 5软件进行t检验、χ2 检验。结果 ①具有完整随访资料 74例 ,手术后复发 4 0例(5 4 % ) ,其中阴道穹隆脱垂 2 3例 (Ⅰ度 2 1例 ,Ⅱ度和Ⅲ度分别为 1例 ) ,阴道前壁膨出 2 8例 (Ⅰ度 2 1例 ,Ⅱ度6例 ,Ⅲ度 1例 ) ,阴道后壁膨出 11例 (Ⅰ度 7例 ,Ⅱ度和Ⅲ度分别为 2例 ) ;②复发组平均年龄 (6 9 1± 5 7)岁 ,显著高于未复发组 (6 4 7± 9 3)岁 (P <0 0 5 ) ;③两组绝经年龄、孕次、产次、首娩年龄、末娩年龄、分娩方式差异均无显著性 (P >0 0 5 ) ;④复发组长期便秘人数 (16 /40 )显著高于未复发组 (6 /34) (P <0 0 5 )。⑤不同途径的子宫切除方式以及进行和未进行会阴修补及肛提肌加固术在术后复发上差异无显著性 (P >0 0 5 )。⑥复发组术后恢复不佳的患者人数 (2 1/40 )显著高于未复发组 (6 /34) (P <0 0 1)。结论 ①盆腔器官脱垂有较高的术后复发率 ;②复发的危险因素有?
Objective To evaluate the relapse rate in patients with pelvic organ prolapse(POP) who underwent surgery and identify related factors of the relapse. Methods Seventy four patients who underwent surgery for POP in our department from July,1999 to February 2004 and had following-up information were analyzed retrospectively. The follow-up information included questionnair survey and pelvic examination. The patients were divided into two groups: relapse group and non-relapse (control) group. The clinical characteristics, operative and postoperative data of the two groups were compared respectively. Results ① Fourty patients were found recurrence (54%). Of which, vaginal vault prolapse were 23 cases, anterior vaginal wall prolapse were 28 cases and posterior vaginal wall prolapse were 11 cases. ② The average age of patients in relapse group(69.1±5.7yrs) was significantly than that of those without relapse(64.7±9.3)yrs (P<0.05).③ In aspects of menopausal age、gestation、parity、the first and last delivery age、delivery ways, there were no significantly difference between the two groups(P>0.05). ④ Patients with chronic conspitation in relapse group were significantly more common than that in the control group (P<0.05). ⑤ No significant difference of relapse was found among variable hysterectomy, with and without perineum repaired surgery and levator ani reinforced surgery (P>0.05). ⑥ Postoperative terrible recover was significantly more common in relapse group than that in the control (P<0.01). Conclusions ① There is a high relapse rate for POP patients who undergo traditional surgery. ② Age, chronic constipation and postoperative terrible recover are the recurrent factors of POP postoperation. ③ Menopausal ages, parity,delivery ways, variable hysterectomy have no significant relationship with POP relapse.④ Perineum repairing and levator ani reinforcing surgery seem cannot prevent the relapse. Traditional antrerior or posterior vaginal wall repair can not effectively prevent relapse too.
出处
《中国妇产科临床杂志》
2005年第1期8-12,共5页
Chinese Journal of Clinical Obstetrics and Gynecology
