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目的:观察应用网片治疗盆底功能障碍性疾病(pelvic floor dysfunction,PFD)的临床效果。方法:2009年1月～2012年4月应用网片治疗30例PFD患者,其中行全盆底重建术(proliftTM)10例,前盆腔盆底重建术(prolift A)+阴道后壁修补术12例(联合会阴修补术6例),TVT-O术8例;保留子宫4例,阴式子宫切除17例,宫颈截除2例。观察术中及术后恢复情况,采用POP-Q分期评分作为临床疗效评价指标。结果:30例手术均成功完成,平均手术时间(93.33±44.18)min,网片放置时间(17.6±6.66)min,平均出血(108.3±86.51)ml;术中无1例膀胱、尿道、直肠、血管损伤。术后随访6月～3年,所有患者症状全部改善,无复发病例。1例盆底重建患者术后18个月阴道前壁网片侵蚀,2例觉下腹部坠痛,3例自觉轻微大腿根部疼痛;5例术后3个月恢复性生活,1例因网片侵蚀有异物感,余无不适。结论:应用网片治疗盆底功能障碍性疾病效果明显,但有一定的并发症;加强术前评估、沟通及准备,精细手术操作,严密术后随访,可有效减少手术远期并发症。
Objective: To observe the clinical effect of using mesh in the treatment of pelvic floor dysfunction (PFD). Methods: From January 2009 to April 2012, 30 patients with PFD were treated with mesh, including 10 cases of proliftTM, 10 cases of prolift A + vaginal posterior wall repair Cases (Federation of yin repair surgery in 6 cases), TVT-O surgery in 8 cases; retained uterus in 4 cases, vaginal hysterectomy in 17 cases, cervical resection in 2 cases. Observed intraoperative and postoperative recovery, the use of POP-Q staging score as a clinical evaluation indicators. Results: All the 30 surgeries were completed successfully. The mean operation time was (93.33 ± 44.18) min, mesh placement time was (17.6 ± 6.66) min and average bleeding was (108.3 ± 86.51) ml. There was no bladder, urethra, rectum, Vascular injury. All the patients were followed up for 6 months to 3 years. All patients showed no symptoms of recurrence. One case of pelvic floor reconstruction eroded anterior vaginal mesh 18 months postoperatively, 2 cases felt lower abdomen pain, 3 cases consciously minor thigh root pain; 5 cases recovered 3 months postoperative life, 1 case due to mesh Erosion of foreign body sensation, I have no discomfort. Conclusion: The application of mesh in the treatment of pelvic floor dysfunction is effective, but there are some complications. To strengthen preoperative evaluation, communication and preparation, fine operation and strict follow-up after operation can reduce long-term complications effectively.