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目的探讨阴式子宫切除联合阴道前后壁修补术治疗老年严重子宫脱垂伴全阴道膨出患者的临床疗效及术后疼痛反应。方法回顾性分析2014年2月至2015年2月收治的103例老年严重子宫脱垂伴全阴道膨出患者的临床资料。以常规手术治疗的52例为对照组,以阴式子宫切除联合阴道前后壁修补术治疗的51例为观察组。比较两组的临床效果及术后疼痛反应情况。结果对照组的手术时间[(85.25±5.24)min vs(68.15±2.25)min]显著长于观察组,术中出血量[(481.25±10.23)ml vs(380.25±12.12)ml]显著大于观察组,肛门排气时间[(27.35±8.26)h vs(18.12±10.11)h]和住院天数[(15.12±2.15)d vs(7.25±2.11)d]均显著长于观察组,差异均有统计学意义(P均<0.01)。对照组术后1、3、7 d的疼痛VAS评分[(6.8±0.3)vs(5.2±0.3),(5.1±0.2)vs(2.1±0.2),(4.3±0.2)vs(1.0±0.1)]均显著高于观察组,差异均有统计学意义(P均<0.05)。对照组的并发症发生率稍高于观察组,但差异无统计学意义(13.46%vs 3.92%,P>0.05)。结论对老年严重子宫脱垂伴全阴道膨出患者实施阴式子宫切除联合阴道前后壁修补治疗可以获得较常规手术治疗更好的临床效果。
Objective To investigate the clinical efficacy and postoperative pain response of vaginal hysterectomy combined with vaginal anterior and posterior wall repair in the treatment of elderly patients with severe uterine prolapse and full vaginal prolapse. Methods The clinical data of 103 elderly patients with severe uterine prolapse and total vaginal prolapse admitted from February 2014 to February 2015 were analyzed retrospectively. Fifty-two patients underwent routine surgery as control group, and 51 cases treated by vaginal hysterectomy combined with vaginal anterior and posterior wall repair as observation group. The clinical effects and postoperative pain response were compared between the two groups. Results The operative time of the control group [(85.25 ± 5.24) min vs (68.15 ± 2.25) min] was significantly longer than that of the observation group. The amount of blood loss in the control group [(481.25 ± 10.23) ml vs (380.25 ± 12.12) ml] The time of anus evacuation was significantly longer than that of the observation group [(27.35 ± 8.26) h vs (18.12 ± 10.11 h) and length of stay [(15.12 ± 2.15) days vs (7.25 ± 2.11) days, respectively) P <0.01). The VAS scores of pain in the control group at 1, 3 and 7 days after operation were significantly higher than those in the control group [(6.8 ± 0.3) vs (5.2 ± 0.3), (5.1 ± 0.2) vs (2.1 ± 0.2) ] Were significantly higher than the observation group, the differences were statistically significant (P all <0.05). The incidence of complications in the control group was slightly higher than that in the observation group, but the difference was not statistically significant (13.46% vs 3.92%, P> 0.05). Conclusion Vaginal hysterectomy combined with vaginal anterior and posterior wall repair in elderly patients with severe uterine prolapse and full vaginal prolapse can achieve better clinical results than conventional surgical treatment.