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目的探讨阴式中盆腔重建术治疗以中盆腔缺陷为主的盆腔器官脱垂(POP)的临床疗效。方法回顾性分析2012年1月至2014年6月在中国医科大学附属盛京医院因以中盆腔缺陷为主的盆腔器官脱垂需要手术治疗的68例患者的临床资料,按手术术式不同进行分组:48例行阴式中盆腔重建术,20例行腹腔镜下阴道骶骨固定术。分别于术后3、6、12个月门诊复查。结果 48例采用阴式中盆腔重建术患者术后均未见复发,POP量化分级(POP-Q)测定各指示点均在正常范围,客观治愈率达100%,主观症状复发2例,主观治愈率95.8%;20例采用腹腔镜下阴道骶骨固定术患者中,术后复发3例,POP-Q评分均为Ⅱ度,复发部位主要为阴道后壁,客观治愈率85%,主观症状复发4例,包括膀胱排空有困难,压力性尿失禁等,主观治愈率80%,差异有统计学意义(P<0.05)。结论阴式中盆腔重建术在治疗以中盆腔缺陷为主的盆腔器官脱垂上疗效明确,主、客观治愈率均优于腹腔镜下阴道骶骨固定术。
Objective To investigate the clinical effect of pelvic reconstruction in vaginal therapy for pelvic organ prolapse with predominant pelvic defects. Methods The clinical data of 68 patients who needed surgical treatment of pelvic organ prolapse with pelvic defects at Shengjing Hospital of China Medical University from January 2012 to June 2014 were retrospectively analyzed, Grouping: 48 cases of vaginal pelvic reconstruction, 20 cases of laparoscopic vaginasacral fixation. Respectively 3,6,12 months after the clinic review. Results No recurrence was found in 48 patients undergoing pelvic reconstructive surgery. POP-Q (POP-Q) was used in the normal range. The objective cure rate was 100%, subjective symptom recurred in 2 cases and subjective cure The rate of 95.8%; 20 cases of laparoscopic vaginas sacral fixation in patients with postoperative recurrence in 3 cases, POP-Q score were grade Ⅱ, the main recurrence of the vaginal wall, the objective cure rate of 85%, subjective symptoms of recurrent 4 Cases, including bladder emptying difficulties, stress urinary incontinence, subjective cure rate of 80%, the difference was statistically significant (P <0.05). Conclusion pelvic reconstruction in vaginal pelvic organ prolapse in the treatment of pelvic organ prolapse clear effect, the main and objective cure rates are better than laparoscopic vaginasacral fixation.