摘要
目的:评价无穿刺加用网片盆底重建术治疗症状性Ⅱ～Ⅲ度盆腔器官脱垂的近期疗效。方法:对盆腔器官脱垂定量系统(POP-Q)评价为Ⅲ度的8例盆腔器官脱垂患者行阴式子宫切除术加无穿刺加用网片盆底重建术(PROSIMA盆底重建术),采用主观评价[盆底功能障碍影响问卷简版(PFIQ-7)评分]和客观评价(POP-Q)等方法对围手术期及术后近期各项指标的变化及并发症发生情况进行分析。结果:中位手术时间为60分钟(54～65分钟),中位术中出血量55ml(30～90m1);无术中并发症;88%(7/8)的患者手术次日即拔除尿管,且残余尿量<100ml;术后病率为0;中位术后住院时间3天(3～6天)。中位随访时间4个月(1～6个月)。术后随访POP-Q评分,手术有效率达100%;仅1例患者诉术后阴道分泌物增多。术后半年内随访所有患者未出现下尿路感染、新发尿失禁、网片侵蚀、下肢疼痛等并发症,且症状得以改善。PFIQ-7评分较术前有显著改善。结论:PROSIMA盆底重建术易于掌握,创伤小、无术后疼痛等并发症,术后近期疗效好,远期疗效尚待循证。
Objective：To evaluate short-term clinical effects of mesh-utilizing pelvic floor reconstruction without puncture in the treatment of symptomatic moderate to severe pelvic organ prolapse.Methods：eight patients with POP-Q（pelvic organ prolapse quantification） stage 3 had TVH（Hysterectomy） ＋ mesh-utilizing pelvic floor reconstruction without puncture（PROSIMA pelvic floor reconstruction）.Peri-operative clinical parameters,short term outcomes after surgery and complications were analyzed by objective method（PFIQ-7） and subjective method（POP-Q）.Results：Median operation time was 60 minutes（54～65 minutes）,median blood loss was 55 ml（30～90ml）.No severe intra-operative complications were recorded.88%（7/8） patients were able to micturate spontaneously in the next morning after surgery with postvoid residual volume less than 100 ml.Postoperative morbidity was zero.Median post-operative hospital stay was 3 days（3～6 days）.The median follow up time was 4 months（1～6 months）.According to POP-Q system evaluation,the successful rate of operation reached 100%（8/8）;only one patient complained that increased vaginal excretion after surgery.No postoperative complications,such as urinary tract infection,incontinence,mesh exposure,or pain in lower extremities were found.100%（8/8） patients reported that the subjective symptoms remissed,with PFIQ-7 scores significantly improved compared with baseline.Conclusions：PROSIMA pelvic floor reconstruction is a micro-invasive and efficient procedure with few complications.However,a long-term follow-up is necessary to detect any late complication and further clinical studies are required to establish the role of this surgery.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2011年第3期201-203,共3页
Journal of Practical Obstetrics and Gynecology
关键词
盆腔器官脱垂
无穿刺盆底重建术
网片
近期疗效
Pelvic organ prolapse
Pelvic floor reconstruction without puncture
Mesh
Short-term effect
