国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2014, Vol. 33 ›› Issue (1): 24-26.

• 论著 • 上一篇    下一篇

盆腔器官脱垂泌尿控制研究及手术方式比较

赵琳，向梅，夏婷婷，曾克非，许为   

  1. 130041 长春，吉林大学第二临床医院妇产科（赵琳，向梅，许为）；河北省秦皇岛市妇幼保健院（夏婷婷，曾克非）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-01-15 发布日期:2014-01-15
  • 通讯作者: 许为

Study on the Short Efficacy of Surgical Operation，and the Urinary Control Situation in Patients with the Female Pelvic Organ Prolapse

ZHAO Lin，XIANG Mei，XIA Ting-ting，ZENG Ke-fei，XU Wei   

  1. Department of Obstetrics and Gynecology，The Second Hospital of Jilin University，Changchun 130041，China（ZHAO Lin，XIANG Mei，XU Wei）；Maternity and Child Care Center of Qinhuangdao，Qinhuangdao 066000，Hebei Province，China（XIA Ting-ting，ZENG Ke-fei）
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-01-15 Online:2014-01-15
  • Contact: XU Wei

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摘要： 目的：分析探讨常用治疗盆腔器官脱垂（POP）术式的疗效。方法：回顾性分析2009年1月—2011年12月诊断并行手术治疗的患者262例，可以随访到的患者213例，随访率78%，术后随访时间1年。包括Prolift盆底重建手术组77例，改良盆底重建手术组65例，传统手术组（阴式子宫切除术+阴道前后壁修补术）71例。合并压力性尿失禁（SUI）的患者术中同时行经闭孔无张力尿道中段悬吊术（TVT-O）。通过术后随访，比较3种手术方式治疗POP的近期疗效、SUI纠正情况以及术后压力性尿失禁（POSUI）的出现情况。结果：无论术前是否行简单尿动力学检查（不包含压力传导率等测定），均不能有效预测POSUI的发生，不同手术方式POSUI的发生率差别无统计学意义；3种手术方式同期TVT-O手术治疗SUI的有效率均在90%以上；3种手术方式治疗POP的疗效差异有统计学意义（P＜0.05），Prolift手术组及改良手术组的疗效优于传统手术组。结论：简单尿动力检查对POSUI的发生无预测价值。Prolift盆底重建术、改良式盆底重建术以及传统的阴道前后壁修补术，术中同期行TVT-O手术均能够达到治疗SUI理想的效果。Prolift及改良式盆底重建术治疗POP的近期疗效均优于传统的阴道前后壁修补术。

关键词: 骨盆, 脱垂, 尿失禁, 压力性, 外科手术, 微创性

Abstract: Objective：To evaluate the clinical short efficacy of the Prolift pelvic reconstruction surgery，and the urinary control status，in patients with the female pelvic organ prolapse. Methods：This is a retrospective analysis of 213 patients with female pelvic floor dysfunction，and with the pelvic reconstruction surgery，from our hospital from January 2009 to December 2011. 213 cases were divided into 3 groups according to three different surgical methods：the Prolift method group with 77 cases，the modified method group with 65 cases （modified pelvic floor reconstruction operation），and the traditional method group with 71 cases（vaginal hysterectomy associated with vaginal wall repair operation）. Those patients suffering from stress urinary incontinence were treated with anti-stress urinary incontinence treatment. After one year of follow-up visit，the pelvic organ prolapse recovery，the stress urinary incontinence correction，and the occurrence of occult urinary incontinence were compared in three groups. Results：In the same group，POSUI （stress urinary incontinence after operation） was independent on the urodynamic examination before operation. The difference of POSUI rates in three different groups was not significant. The effective rates of the TVT-O operation in three groups，as for treatment of stress urinary incontinence at same stages，were above 90%. The effective rates in three groups，as for treatment of the pelvic organ prolapse （POP），were significant different （P＜0.05）. The efficiency in the Prolift method group was better than those in other groups. Conclusions：It was suggested that the urodynamic examination before the operation has not prognosis effect on POSUI. The Prolift operation，the modified pelvic floor reconstruction，as well as the traditional operation，if combined with TVT-O operation，can achieve ideal effect in treatment of SUI. The curative effects of the Prolift and modified methods were better than that of the traditional method.

Key words: Pelvis, Prolapse, Urinary incontinence, stress, Surgical procedures, minimally invasive