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盆底重建手术治疗老年女性重度盆腔器官脱垂的临床分析

Clinical analysis of Prolift pelvic reconstructive surgery for advanced pelvic organ prolapse in elderly women

摘要:

目的 探讨盆腔重建Prolift手术治疗老年女性重度盆腔器官脱垂(POP)的疗效、安全性及对盆底功能和性功能的影响. 方法 采用经阴道盆腔重建Prolift手术治疗老年女性重度POP患者42例,POP-Q法分期均为Ⅲ~Ⅳ期,年龄60~79岁,平均(68±8)岁,观察手术时间、出血量及并发症,分别于术后1、6个月随访手术疗效,并对手术前后的盆底功能障碍问卷简表(PFDI-20)、盆底功能影响问卷简表(PFIQ7)及性功能调查问卷评分(PISQ-31)进行比较. 结果 42例患者的手术时间为35~78min,平均(42±25)min,术中出血量50~300ml,平均(137±58)ml,无手术其他损伤、死亡,无术中术后并发症.42例患者术后全部治愈,无复发.患者术后1个月、6个月PFDI-20、PFIQ-7分别为(4.5±1.4)分和0分(7.8±4.3)分才0分,较术前(47.9±12.2)分、(76.3±17.9)分降低(P<0.01);术后1、6个月PISQ-31分别为(49.8±6.3)分、(51.1±6.5)分,与术前(52.3±4.3)分比较,差异无统计学意义(P>0.05). 结论 Prolift手术治疗老年重度POP安全,能改善老年患者的生活质量.

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abstracts:

Objective To evaluate the safety and efficacy of Prolift pelvic reconstructive surgery for advanced pelvic organ prolapse in elderly patients,and to investigate its impact on pelvic floor function and sexual function.Methods Totally 42 patients aged 60-79 years with advanced pelvic organ prolapse [Pelvic Organ Prolapse Quantification (POP-Q) stage Ⅲ,n=30; POP-Q Ⅳ,n=12)were selected in this study.All patients underwent total Prolift procedure,and were followed up at month 1 and 6 after operation.Operation time,bleeding volume and postoperative complications were recorded.The impact of total Prolift procedure on pelvic floor function in patients were assessed by pelvic floor distress inventory short form 20 (PFDI-20),the pelvic floor incontinence questionnaire 7 (PFIQ-7) and the pelvic organ prolapsed and incontinence sexual quality questionnaire 31 (PISQ-31).Results The operative time was (35-78) minutes[mean time:(42±25) minutes].Bleeding volume was (50 300) ml [mean volume:(137±58) ml].No bladder injury,rectum injury and postoperative complications were observed.All patients were cured,and no one recurred.The scores of PFDI-20 and PFIQ-7 were decreased in patients after sugery at 1 and 6-month follow-up as compared with beforesugery (4.5±1.4,0 vs.47.9±12.2; 7.8±4.3,0 vs.76.3±17.9,respectively,all P<0.01).There were no significant differences in scores of PFIQ-7 between before and after sugery at 1-and 6-months follow-up (52.3±4.3 vs.49.8±6.3,51.1±6.5,P>0.05).Conclusions Prolift pelvic reconstructive surgery is an safe and effective treatment for advanced pelvic organ prolapse,which can significantly improve quality of life in elderly patients.

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