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目的:分析盆底重建术后网片侵蚀暴露相关因素及远期临床疗效。方法:选取2007年1月至2014年4月在郑州大学第三附属医院采用聚丙烯网片行盆底重建术的142例盆底器官脱垂患者,分析其术后复发及网片侵蚀暴露等并发症情况。同时选取2006年2月至2014年2月因子宫脱垂或阴道前后壁膨出行传统手术治疗的68例盆底器官脱垂患者为对照。结果:盆底重建术后复发率为2.1%(3/142),传统手术复发率为2.9%(2/68);盆底重建术的网片侵蚀暴露发生率为15.49%(22/142)。有糖尿病病史与盆底重建术后网片侵蚀暴露有关(P<0.05),保留子宫则是其保护因素(P<0.05)。使用网片的盆底重建术患者的术后并发症发生率明显高于对照组(P<0.05),术后长期并发症发生率则少于短期,差异有统计学意义(P<0.05)。结论:利用聚丙烯网片进行盆底重建术疗效确切,复发率低;控制糖尿病及保留子宫的盆底重建手术可能降低术后网片侵蚀暴露的发生,术后长期临床效果可能较短期有所改善。使用网片的盆底重建手术术后并发症较传统手术高。
OBJECTIVE: To analyze the related factors and long-term clinical efficacy of post-pelvic reconstruction erosive exposure. Methods: From January 2007 to April 2014, 142 patients with pelvic floor organ prolapse who underwent pelvic floor reconstruction with polypropylene mesh in the Third Affiliated Hospital of Zhengzhou University were enrolled. The postoperative recurrence and exposure to mesh erosion Complications. At the same time, 68 patients with pelvic organ prolapse who underwent traditional surgical treatment of uterine prolapse or vaginal anterior and posterior wall bulging were selected as control from February 2006 to February 2014. Results: The recurrence rate after pelvic floor reconstruction was 2.1% (3/142), the recurrence rate was 2.9% (2/68) in conventional pelvic floor reconstruction and 15.49% (22/142) in pelvic floor reconstruction. . The history of diabetes mellitus was related to the exposure of the eyelid to pelvic floor reconstruction (P <0.05), and retention of the uterus was the protective factor (P <0.05). The incidence of postoperative complications in patients undergoing pelvic floor reconstruction with mesh was significantly higher than that in control group (P <0.05). The incidence of postoperative long-term complications was less than that in short-term. The difference was statistically significant (P <0.05). Conclusions: The pelvic floor reconstruction using polypropylene mesh is effective and the recurrence rate is low. Pelvic floor reconstruction surgery to control diabetes and preserve the uterus may reduce the occurrence of postoperative mesh erosion exposure. The long-term postoperative clinical effect may be short-term improve. The use of mesh pelvic floor reconstruction surgery postoperative complications than traditional surgery.