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目的探讨阴式子宫切除加阴道前后壁修补术对子宫脱垂伴阴道前壁或后壁脱垂患者盆底功能的近期影响。方法选择2010年1月至2011年5月于广州医科大学附属第三医院因子宫脱垂伴阴道前壁或后壁脱垂行阴式子宫切除加阴道前后壁修补术治疗的49例患者为研究对象,于术前、术后两年行妇科检查及相关问卷调查,从阴道壁脱垂、大小便情况、性生活及盆底肌力等方面评价经阴式子宫切除加阴道前后壁修补术对这些患者近期盆底功能的影响。结果 49例患者中术后两年阴道前壁或后壁脱垂例数较术前明显减少(P<0.05);术后两年尿失禁问卷简表评分为(3.5±0.5)分,术前评分为(6.5±0.8)分,差异有统计学意义(P<0.05);术后两年尿垫试验阳性率为14.29%,术前阳性率为57.14%(P<0.05);术后两年有尿失禁或便秘、大便次数增多、大便时下坠感患者较术前明显减少,差异有统计学意义(P<0.05)。术后有性生活患者性生活质量不满意。术前、术后两年的盆底肌张力及收缩力无明显变化,差异无统计学意义(P>0.05)。结论阴式子宫切除加阴道前后壁修补术对盆腔器官脱垂患者短期内疗效显著,近期盆底功能影响尚小。
Objective To explore the immediate effect of vaginal hysterectomy plus vaginal anterior and posterior wall repair on pelvic floor function in uterine prolapse patients with vaginal anterior or posterior wall prolapse. Methods From January 2010 to May 2011 in Guangzhou Medical University Affiliated Third Hospital due to uterine prolapse with vaginal anterior or posterior vaginal wall vaginal hysterectomy plus vaginal anterior and posterior wall repair of 49 patients for the study Subjects underwent gynecological examinations and related questionnaires two years before and after surgery. Vaginal hysterectomy plus vaginal anterior and posterior wall repair were evaluated in terms of vaginal wall prolapse, urine and urine, sex life and pelvic floor muscle strength The recent pelvic floor function of these patients. Results The number of prolapse of anterior vaginal wall or posterior wall in 49 patients was significantly decreased than that before operation (P <0.05). The score of urinary incontinence questionnaire was (3.5 ± 0.5) (P <0.05). The positive rate of urine pad test in two years after operation was 14.29%, the positive rate was 57.14% (P <0.05) before operation and two years after operation Patients with urinary incontinence or constipation, stool frequency increased, stool flu decreased significantly compared with preoperative, the difference was statistically significant (P <0.05). Patients with sexual life after sexual life quality is not satisfied. Preoperative and postoperative pelvic floor muscle tension and contractility no significant change, the difference was not statistically significant (P> 0.05). Conclusion Vaginal hysterectomy plus vaginal anterior and posterior wall repair of pelvic organ prolapse in patients with short-term significant effect, the recent pelvic floor function is still small.