目的:探讨改良LeFort阴道封闭术与改良全盆底重建术对老年女性重度盆腔器官脱垂(pelvic organ prolapse，POP)的影响。方法:选取 2016 年 2 月 17 日—2021 年 2 月 17 日贵州医科大学附属医院妇科收治的 82 例老年重度POP女性。根据随机抽签方式将其分成对照组和试验组，各41例。对照组给予改良LeFort阴道封闭术，试验组给予改良全盆底重建术。比较两组围手术期指标，相关指标，术前、术后半年临床症状及生活质量，术前、术后1周排尿、排便情况。结果:两组手术时间、住院时间、留置尿管时间、术中出血量比较，差异无统计学意义(P>0。05)。试验组治愈率高于对照组，复发率、新发压力性尿失禁发生率、再次手术发生率均低于对照组，差异有统计学意义(P<0。05)。术后半年，两组盆底功能障碍问卷(pelvic floor distress inventory-short form 20，PFDI-20)评分、盆底功能影响问卷简表(pelvic floor impact questionnaire--short form 7，PFIQ-7)评分降低，试验组PFDI-20评分、PFIQ-7评分均低于对照组，差异有统计学意义(P<0。05)。术后1周，试验组尿急、尿频、排尿困难、排便困难发生率均低于对照组，差异有统计学意义(P<0。05)。结论:改良全盆底重建术更有助于改善患者脱垂复发率，改善患者排尿、排便情况，手术十分安全有效。
Effect of Modified LeFort Vaginal Closure Surgery and Modified Total Pelvic Floor Reconstruction Surgery on Severe Pelvic Organ Prolapse in Elderly Women
Objective:To investigate the effect of modified LeFort vaginal closure surgery and modified total pelvic floor reconstruction surgery on severe pelvic organ prolapse(POP)in elderly women.Method:From February 17,2016 to February 17,2021,82 elderly women with severe POP admitted to the Department of Gynecology in Affiliated Hospital of Guizhou Medical University were selected.They were divided into control group and experimental group according to random drawing method,with 41 cases in each group.The control group was given modified LeFort vaginal closure surgery,and the experimental group was given modified total pelvic floor reconstruction surgery.The perioperative indexes,related indexes,clinical symptoms and quality of life before and half a year after surgery,urination and defecation condition before and 1 week after surgery were compared between the two groups.Result:There were no significant differences in surgery time,hospital stay,catheter indwelling time and intraoperative blood loss volume between the two groups(P>0.05).The cure rate of experimental group was higher than that of control group,the recurrence rate,the incidence of new stress urinary incontinence and the incidence of reoperation were lower than those of control group,and the differences were statistically significant(P<0.05).Half a year after surgery,pelvic floor distress inventory-short form 20(PFDI-20),pelvic floor impact questionnaire--short form 7(PFIQ-7)scores decreased in the two groups,and the PFDI-20 and PFIQ-7 scores of experimental group were lower than those of control group,the differences were statistically significant(P<0.05).At 1 week after surgery,the incidences of urgent urination,frequent micturition,difficulty urinating and defecation in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:Modified total pelvic floor reconstruction surgery is more helpful to improve the prolapse recurrence rate of patients,and improve patients'urination and defecation conditions.The surgery is very safe and effective.
万方数据
维普
