摘要
目的探讨聚丙烯网片盆腔悬吊术治疗女性盆腔脏器脱垂(pelvic organ prolapse,POP)的疗效。方法回顾性分析2003年12月～2008年12月我院应用国产穿刺锥行网片介入手术治疗79例POP的临床资料,评估该术式的治愈率、并发症、复发率和新盆腔症状。POP分级采用盆腔器官脱垂量化系统(POP-Q)评定,泌尿生殖道症状问询采用盆底功能障碍疾病相关问卷(PFDI-20)。结果术后1年POP治愈68例(86.1%),好转8例(10.1%)。术后3个月内POP复发1例(1.3%),再次手术随访2年末复发;术后>1年POP复发3例(3.8%)。排尿障碍术后3个月内发生2例(2.5%),术后>1年发生1例(1.3%)。网片腐蚀术后3个月内发生5例(6.3%),术后>1年发生3例(3.8%)。术后1年出现性生活不适或疼痛4例(5.1%),术后出现膀胱过度活动症(overactive bladder,OAB)5例(6.3%),与网片相关的疼痛1例(1.3%)。结论聚丙烯网片POP腔悬吊术治疗盆疗效满意,复发率低,最多见的并发症是网片腐蚀,新出现的问题是OAB。
Objective To assess the clinical outcomes of pelvic organ prolapse （POP） suspension with a domestic trocar-guided surgical device using polypropylene mesh. Methods From December 2003 to December 2008, totally 79 patients with POP underwent pelvic floor repair in our hospital. We analyzed the follow-up data of the patients including the cure and recurrence rates, complications, and new pelvic symptoms after transvaginal mesh technique. Pelvic Organ Prolapse Quantification System （POP-Q） was employed to evaluate the grade of POP, and Pelvic Floor Distress Inventory-short Form 20 （PFDI-20） was used for symptom assessment. Results In our series, 1-year cure rate was 86.1% （68/79）, and rate of improvement was 10.1% （8/79）. Recurrent POP was detected in less than 3 months in 1 case （1.3%）, and in over one year in 3 cases （3.8%）. After the operation, 2 patients （2.5%） developed dysuria in less than 3 months and 1 patient （1.3%） in over 1 year. In 5 patients （6.3%）, the mesh erosion occurred in less than 3 months, and 3 cases （3.8%） in over 1 year. Sex life complaint occurred in 4 cases （5.1%）; overactive bladder （OAB） in 5 cases （6.3%）; and mesh-related tension was noticed in 1 case （1.3%）. Conclusions Correct choice of surgical treatment can reduce the recurrence of POP. Problems with mesh implantation, including ＂erosion＂, mesh-related tension, have called attention to further improve our operation skill, and implanting materials, as well as operation equipments. OAB may be related to patient’s age, and the nature of the urinary incontinence.
出处
《中国微创外科杂志》
CSCD
2010年第6期541-544,共4页
Chinese Journal of Minimally Invasive Surgery
