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目的:探讨补片(Mesh)在子宫切除术后阴道脱垂患者盆底功能重建手术中的应用效果,并评价其疗效与安全性。方法:对2001年1月～2007年1月经阴或经腹行子宫切除术后再发阴道脱垂的31例患者采用聚丙烯网片进行阴道前后壁修补术,根据临床检查及主诉对手术前后脱垂情况进行评估,观察疗效并定期随访。结果:手术时间平均为110min,出血量平均为150ml。31例患者术后均恢复良好,术后3～6天出院,术后1、3、9、12、18个月随访,平均随访时间15.3个月(12～18个月),随访率100%。发现2例补片侵蚀阴道黏膜,发生率为6.45%,其中1例为前壁补片,1例为后壁补片。无补片感染发生。根据国际尿控协会制定的盆腔脏器脱垂定量分度法客观评估阴道前后壁及穹窿脱垂等情况,症状全部得到纠正,无复发,无阴道扭曲和缩短,大部分患者无性生活障碍,性生活满意度达90%。结论:补片在女性盆底重建手术中的应用,方法简单,操作容易,不延长手术时间,患者耐受性好,复发率低,值得临床进一步推广。
Objective: To investigate the effect of Mesh in pelvic floor reconstruction after hysterectomy and evaluate its curative effect and safety. Methods: From January 2001 to January 2007, 31 patients with recurrent vaginal prolapse after transvaginal or abdominal hysterectomy were treated with polypropylene mesh for vaginal anterior and posterior wall repair. According to clinical examination and chief complaint, Prolapse situation assessment, observation of efficacy and regular follow-up. Results: The average operation time was 110min, the average amount of bleeding was 150ml. All 31 patients recovered well after operation, and were discharged from 3 to 6 days after operation. The patients were followed up at 1, 3, 9, 12 and 18 months after operation. The mean follow-up time was 15.3 months (range, 12-18 months) . Two cases of vaginal mucosa erosion were found, the incidence was 6.45%. One of them was anterior wall patch and the other one was posterior wall patch. No patch infection occurs. According to the International Association of Urine Control to develop pelvic organ prolapse quantitative indexing method to objectively assess the vaginal anterior and posterior wall and vault prolapse and so on, the symptoms were all corrected, no recurrence, no vaginal distortion and shortening, most patients with asexual life disorder, sexual Life satisfaction up to 90%. Conclusion: The application of patch in pelvic floor reconstruction surgery is simple, easy to operate, does not extend the operation time, patient tolerance is good, the recurrence rate is low, it is worth further clinical promotion.