【摘要】 目的探讨经阴道髂尾肌筋膜固定术联合经阴道全子宫切除术+阴道前、后壁修补术治疗盆腔脏器脱垂(POP)的应用价值。方法选取2014年1月至2015年12月,广东省河源市龙川县人民医院与广东省佛山市南海区第六人民医院收治的98例POP患者为研究对象。根据POP患者接受的手术治疗方式,将其分为观察组(n=48,接受经髂尾肌筋膜固定术联合经阴道全子宫切除术+阴道前、后壁修补术治疗)与对照组(n=50,仅接受经阴道全子宫切除术+阴道前、后壁修补术治疗)。统计学比较2组患者的一般临床资料、手术时间、术中出血量、术后胃肠功能恢复时间、住院时间、治疗费用、治疗有效率、不良反应率,以及复诊时感染率、手术创面愈合不良发生率及复发率。结果①2组患者年龄、人体质量指数、产次、绝经时间及POP量化分期法(POP-Q)分度、合并症构成比等一般临床资料分别比较,差异均无统计学意义(P>0.05)。②2组患者手术时间及术中出血量比较,差异均无统计学意义(P>0.05)。观察组患者术后胃肠功能恢复时间为(8.5±2.7)h,较对照组的(10.6±3.2)h短,并且差异有统计学意义(t=3.504,P=0.035)。③观察组患者住院时间为(8.4±1.2)d,较对照组的(10.5±1.7)d短,差异有统计学意义(t=7.038,P<0.001)。观察组治疗费用为(6 084.7±844.9)元,较对照组的(6 515.6±1 018.4)元低,并且差异亦有统计学意义(t=2.275,P=0.047)。④观察组治疗有效率为97.9%(47/48),住院期间不良反应率为4.2%(2/48),对照组分别为90.0%(45/50)与8.0%(4/50),二者分别比较,差异均无统计学意义(P>0.05)。复诊时,2组患者感染率、手术创面愈合不良发生率及复发率分别比较,差异均无统计学意义(P>0.05)。结论经阴道髂尾筋膜固定术联合传统术式治疗POP,疗效及安全性较为可靠,并且治疗费用较低。更多还原

【Abstract】 Objective To analyze the value of transvaginal iliococcygeal fixation combined with transvaginal hysterectomy,anterior and posterior colporrhaphy in treatment of pelvic organ prolapse(POP).Methods From January 2014 to December 2015,98 patients with POP in Longchuan County People′s Hospital and the Sixth People′s Hospital of Foshan Nanhai District were chosen as study subjects.According to the surgical method,all patients were divided into study group(n=48,received transvaginal iliococcygeal fixation + transvaginal hysterectomy + anterior and posterior colporrhaphy treatment)and control group(n=50,received transvaginal hysterectomy+anterior and posterior colporrhaphy treatment).The clinical baseline data,surgery duration,transoperative bleeding volume,the recovery time of gastrointestinal function,hospitalization,treatment cost,cure rate,adverse reaction rate,infection rate,unhealing rate of wound and recurrence rate were compared between two groups by statistical methods.Results ①There were no significant differences between two groups in age,body mass index,parity,menopause time,pelvic organ prolapse quantitation(POP-Q)and complications constituent ratio(P>0.05).②There were no significant differences between two groups in transoperative bleeding volume and surgery duration(P>0.05).While the recovery time of gastrointestinal function of study group was(8.5±2.7)h,which was shorter than(10.6±3.2)h of control group,and the difference was statistically significant(t=3.504,P=0.035).③The hospitalization of study group was(8.4±1.2)d,which was shorter than(10.5±1.7)d of control group,and the difference was statistically significant(t=7.038,P<0.001).The treatment cost of study group was(6 084.7±844.9)yuan,which was lower than(6 515.6±1 018.4)yuan of control group,and the difference was statistically significant(t=2.275,P =0.047).④In study group,the cure rate was 97.9%(47/48),the adverse reaction rate during hospitalization was 4.2%(2/48),and in control group,they were 90.0%(45/50)and 8.0%(4/50),respectively,but both the differences were not statistically significant(P>0.05).There were no significant differences between two groups in the infection rate,unhealing rate of wound and the recurrence rate at the time of return visit(P>0.05).Conclusions The effect and safety of transvaginal iliococcygeal fixation combined with transvaginal hysterectomy,anterior and posterior colporrhaphy in treatment of POP are reliable,and its cost is relatively lower.更多还原