本文關(guān)鍵詞： 盆腔器官脫垂 Prolift全盆底重建術(shù) 網(wǎng)片 子宮切除術(shù) 陰道式　出處：《山東大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的 探討經(jīng)陰道植入網(wǎng)片Prolift全盆底重建術(shù)和TVH+陰道前后壁修補(bǔ)術(shù)治療盆腔臟器脫垂性疾病的臨床意義。 方法 回顧分析2006年2月～2014年6月山東省立醫(yī)院40例盆腔臟器脫垂(POP)患者行Prolift全盆底重建術(shù)(研究組)或TVH+陰道前后壁修補(bǔ)術(shù)(對(duì)照組)的療效及并發(fā)癥情況。根據(jù)術(shù)式分為兩組,其中研究組20例,包括研究1組TVH+Prolift全盆底重建術(shù)3例,研究2組單行Prolift全盆底重建術(shù)17例：對(duì)照組20例,行傳統(tǒng)的TVH+陰道前后壁修補(bǔ)術(shù),并評(píng)價(jià)兩組術(shù)后1年內(nèi)各項(xiàng)客觀和主觀指標(biāo)。 結(jié)果 (1)兩組患者的臨床資料包括年齡、絕經(jīng)情況、體重指數(shù)、分娩方式、孕次、產(chǎn)次、兩組患者的POP-Q量化分度及術(shù)后持續(xù)導(dǎo)尿時(shí)間均無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。 (2)手術(shù)時(shí)間、術(shù)中出血量、平均住院時(shí)間研究2組與對(duì)照組有顯著差異,手術(shù)時(shí)間明顯縮短,術(shù)中出血量明顯減少,平均住院時(shí)間減少(P0.05),研究1組與對(duì)照組無(wú)明顯差異(P0.05)。 (3)術(shù)后臨床療效比較：兩組患者出院前測(cè)評(píng)POP-Q,分度均為0度或Ⅰ度。以P-QOL量表評(píng)分作為主觀療效評(píng)價(jià)指標(biāo),主觀滿意度均達(dá)100%。 (4)隨訪：術(shù)后平均隨訪一年,對(duì)照組隨訪率95%,研究組隨訪率100%。POP-Q分度Ⅱ度及Ⅱ度以上判定為復(fù)發(fā),對(duì)照組1例復(fù)發(fā),復(fù)發(fā)率為5%,研究組無(wú)1例復(fù)發(fā)(P0.05)。 結(jié)論 (1)TVH+陰道前后壁修補(bǔ)術(shù)和Prolift全盆底重建術(shù)均是治療POP安全有效的方法。 (2) Prolift全盆底重建術(shù)作為一種新術(shù)式,手術(shù)操作安全、創(chuàng)傷小、并發(fā)癥少,能更好地修補(bǔ)缺陷、重建盆底結(jié)構(gòu)、恢復(fù)盆底功能,且復(fù)發(fā)率低,短期療效穩(wěn)定,長(zhǎng)期療效有待進(jìn)一步隨訪觀察。
[Abstract]:Purpose To investigate the clinical significance of Prolift total pelvic floor reconstruction and TVH vaginal anterior and posterior wall repair in the treatment of pelvic visceral prolapse. Method A retrospective analysis of 40 patients with pelvic organ prolapse (POP) in Shandong Provincial Hospital from February 2006 to June 2014 was performed with Prolift total pelvic floor reconstruction (study group). Or TVH anterior and posterior wall repair (control group), the curative effect and complications were divided into two groups according to the operation method. There were 20 cases in study group, including 3 cases of TVH Prolift total pelvic floor reconstruction in group 1, 17 cases of Prolift total pelvic floor reconstruction in 2 groups and 20 cases in control group. Traditional TVH anterior and posterior wall repair was performed, and objective and subjective indexes were evaluated in both groups within 1 year after operation. Results The clinical data of the two groups included age, menopause, body mass index, mode of delivery, pregnancy and delivery. There was no significant difference in POP-Q quantification and duration of urinary catheterization between the two groups (P 0.05). (2) the operative time, intraoperative bleeding volume, average hospitalization time were significantly different between the two groups, the operative time was shortened, the intraoperative bleeding volume was significantly reduced, and the average hospitalization time was decreased (P 0.05). There was no significant difference between group 1 and control group (P 0.05). (3) comparison of postoperative clinical efficacy: POP-Qs were measured by 0 degree or 1 degree before discharge in both groups. P-QOL score was taken as subjective evaluation index. Subjective satisfaction was 100. (4) Follow-up: the average follow-up rate was one year after operation. The follow-up rate of the control group was 95. The follow-up rate of the study group was 100. POP-Q grade 鈪，

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