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目的:评价盆底功能障碍性疾病(PFD)两种手术方法治疗效果。方法:回顾性分析PFD 58例中32例行阴式子宫切除及阴道前后壁修补术(传统组),26例行保留子宫的盆底重建经及闭孔尿道中段无张力悬吊术(重建组),比较两组手术时间、术中出血、排气时间、住院时间、术后病率及疗效等情况及术后的恢复情况、并发症和临床疗效,并随访其复发率及生活满意度。结果:重建组手术时间、术中出血、排气时间、术后病率分别是(75.4±20.5)min、(69.2±17.7)ml、(27.1±6.3)h、(6.7±0.3)天、2.78%;传统组分别为(138.7±18.6)min、(145.2±44.7)ml、(44.6±4.8)h、(11.4±0.4)天、9.38%,两组差异均有统计学意义(P<0.05)。重建组及传统组总有效率分别为96.78%和76.00%。重建组明显优于传统组(P<0.05)。26例重建组患者手术前后POP-Q指标变化评分,阴道总长度在健康状况、盆腔器官脱垂对其角色、体力、社交、个人关系、情绪及睡眠、性生活影响,脱垂严重程度等方面,术后较术前均显著改善(P=0.000～0.007)。结论:保留子宫的盆底重建及经闭孔尿道中段无张力悬吊术治疗PFD手术时间短、出血少、疗效好、复发率低、技术易掌握,值得推广。
Objective: To evaluate the therapeutic effect of two surgical methods of pelvic floor dysfunction disease (PFD). Methods: 32 cases of PFD were retrospectively reviewed. Vaginal hysterectomy and vaginal anterior and posterior wall repair (traditional group) were performed in 58 cases of PFD. Twenty-six cases of pelvic floor reconstruction with preserved uterus and middle-closed obturator urethral suspension without tension (reconstruction group ), The operation time, intraoperative bleeding, exhaust time, hospital stay, postoperative morbidity and efficacy and postoperative recovery, complications and clinical efficacy were compared, and the recurrence rate and life satisfaction were followed up. Results: The operation time, intraoperative bleeding, exhaust time and postoperative morbidity were (75.4 ± 20.5) min, (69.2 ± 17.7) ml, (27.1 ± 6.3) h, (6.7 ± 0.3) days, % In the traditional group were (138.7 ± 18.6) min, (145.2 ± 44.7) ml, (44.6 ± 4.8) h, (11.4 ± 0.4) days and 9.38% respectively. There was significant difference between the two groups (P <0.05) . The total effective rates of the reconstruction group and the traditional group were 96.78% and 76.00% respectively. The reconstruction group was significantly better than the traditional group (P <0.05). The scores of POP-Q index before and after operation in 26 reconstructed patients, the total length of vagina in health status and pelvic organ prolapse were significantly correlated with their roles, physical strength, social, personal relationships, mood and sleep, sexual life and the severity of prolapse , After operation were significantly improved compared with preoperative (P = 0.000 ~ 0.007). Conclusion: The preservation of the uterus pelvic floor reconstruction and transthoracic urethral tension-free suspension in the treatment of PFD surgery time is short, less bleeding, good effect, low recurrence rate, easy to master the technology, it is worth promoting.