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目的评价全盆底悬吊术治疗盆腔器官脱垂的手术疗效及术后生活质量。方法 2010年1月~2012年12月,在新疆医科大学第一附属医院妇科收治的盆腔器官脱垂患者中,纳入年龄40~60岁、盆腔器官脱垂-Q分期Ⅱ度及以上、行全盆底悬吊术者,共80例。手术前全面评估手术耐受性、盆腔器官脱垂程度及患者尿失禁情况。记录围术期指标。设计生活质量调查表,共包括15项症状,根据症状对患者日常生活影响的程度进行评分,3分为没有影响、2分为轻度影响、1分为中度影响、0分为重度影响。分别于术前、术后6个月及术后1年进行评估。采用重复测量方差分析进行统计学分析。结果 80例患者均无膀胱、直肠、血管及神经等损伤。手术时间为(75.2±3.1)分钟,术中出血量(89.8±31.8)ml,住院时间(7.5±1.3)天。术后6个月及1年随访,无1例发生网片侵蚀并发症。15项症状评分合计,术前为(18.19±0.41)分、术后6个月为(38.59±0.26)分、术后1年为(39.94±0.30)分,术后评分明显高于术前(重复测量方差分析F值为1 837.686,P=0.000)。各项症状分别评分,术后6个月和术后1年的结果也明显高于术前,差异均有统计学意义(P值均﹤0.05)。结论全盆底悬吊术治疗围绝经期盆腔器官脱垂的创伤小,疗效好,安全性高,可明显改善患者的近期生活质量。
Objective To evaluate the surgical treatment effect and postoperative quality of life of pelvic organ prolapse with pelvic floor suspension. Methods From January 2010 to December 2012, patients with pelvic organ prolapse admitted to gynecology department of the First Affiliated Hospital of Xinjiang Medical University were enrolled in this study. Patients aged 40-60 years old with pelvic organ prolapse-Q stage Ⅱ degree and above, Pelvic floor surgery, a total of 80 cases. A comprehensive assessment of surgical tolerance, pelvic organ prolapse, and urinary incontinence was performed prior to surgery. Record perioperative indicators. A total of 15 symptoms were included in the questionnaire. Scores were evaluated based on the degree of influence on the daily life of the patients. Three were categorized as no effect, two as mild, one as moderate, and as 0 as severe. Preoperative, postoperative 6 months and 1 year after surgery were evaluated. Statistical analysis was performed using repeated measures ANOVA. Results None of the 80 patients had bladder, rectum, vascular and nerve injuries. The operation time was (75.2 ± 3.1) minutes, blood loss (89.8 ± 31.8) ml and hospitalization time (7.5 ± 1.3) days. Six months after operation and one year follow-up, none of the patients had mesh erosion complications. The total score of 15 symptoms was (18.19 ± 0.41) points preoperatively, 6 months postoperatively (38.59 ± 0.26) and 1 year postoperatively (39.94 ± 0.30) points postoperatively, which were significantly higher than those of preoperative Repeated measures of variance analysis F value was 1837.686, P = 0.000). The score of each symptom, 6 months after operation and 1 year after operation were significantly higher than those before operation (P <0.05). Conclusion All pelvic floor suspension for the treatment of perimenopausal pelvic organ prolapse less trauma, good effect, high safety, can significantly improve the quality of life of patients in the near future.