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目的探讨改良全盆底重建术(童氏)治疗女性盆底功能障碍性疾病的效果。方法对32例根据POP-Q分度法达Ш度及Ш度以上盆底功能障碍性疾病的女性患者行改良全盆底重建术,应用自制聚丙烯网片对子宫主韧带、骶韧带、阴道前后壁、膀胱宫颈韧带进行全盆底悬吊,合并压力性尿失禁的患者同时进行改良经闭孔尿道中段无张力悬吊术(改良TVT-O术)。结果 32例患者手术全部完成,平均手术时间(98.15±15.14)min,术中平均出血(120.17±40.15)ml,平均住院时间(5.15±2.18)d,术后随访平均为10个月。根据POP-Q分度法及问卷评价手术效果,32例患者手术后盆腔器官脱垂症状全部得以纠正,盆底结构基本正常,所有病例全部治愈。结论上述改良全盆底重建术是一种能治疗多区域、复杂型盆腔器官脱垂的微创手术。在保留子宫的同时能完成全盆底结构和功能的全部或部分重建,手术方法安全、微创。
Objective To investigate the effect of modified pelvic floor reconstruction (Tong’s) on female pelvic floor dysfunction. Methods A total of 32 cases of pelvic floor dysplasia with pelvic floor dysfunction were treated by POP-Q indexing method in 32 female patients with modified pelvic floor reconstruction.Polypropylene mesh was used to treat primary uterine ligaments, sacral ligaments, vagina Anterior and posterior wall, bladder cervical ligament for pelvic floor suspension, combined with stress urinary incontinence in patients with modified transthoracic urethral mid-tension-free suspension (modified TVT-O operation). Results The operation of 32 patients was completed. The average operation time was (98.15 ± 15.14) min. The mean intraoperative bleeding was (120.17 ± 40.15) ml and the average length of stay was (5.15 ± 2.18) d. The average follow - up time was 10 months. According to POP-Q indexing method and questionnaire evaluation of surgical results, all 32 cases of pelvic organ prolapse after surgery were corrected, pelvic floor structure was normal, all cases were cured. Conclusion The modified whole pelvic floor reconstruction is a minimally invasive surgery that can treat multiple regional and complex pelvic organ prolapse. While retaining the uterus can complete the whole pelvic floor structure and function of all or part of the reconstruction, surgical safe, minimally invasive.