全盆底重建术治疗重度盆腔器官脱垂48例临床分析(1)
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[摘要] 目的 探讨全盆底重建术治疗重度盆腔器官脱垂的临床疗效。方法 回顾性分析采用全盆底重建术治疗的48例重度盆腔器官脱垂患者的临床资料。 结果 本组主观治愈率为100%。P-QOL调查结果显示，其生活质量与术前比较有显著性提高(P < 0.05)。结论 全盆底重建术操作安全、微创，并发症少，术后生活质量明显改善，近中期疗效满意，值得临床推广。
[关键词] 盆腔器官脱垂；子宫脱垂；盆底重建；妇科外科手术
[中图分类号] R711.2 [文献标识码] A [文章编号] 1674-4721(2012)02(a)-0033-03
Clinical analysis of 48 cases for whole pelvic floor reconstructive surgery with Gynecare Gynemeshsoft (T-prolift) in treating serious female pelvic organ prolapse (POP)
LI Liwu CAI Huiqun
Gynecology Department of Yueyang Municipal First People's Hospital in Hu'nan Province, Yueyang 414000, China
[Abstract] Objective To investigate the clinical effects of whole pelvic floor reconstructive surgery with Gynecare Gynemeshsoft (T-prolift) in treating serious female pelvic organ prolapse (POP). Methods A retrospective analysis for clinical data of 48 cases who had serious female pelvic organ prolapse (POP) and taken treatment by whole pelvic floor reconstructive surgery with Gynecare Gynemeshsoft (T-prolift). Results The subjective cure rate was 100% of the 48 cases, the P-QOL research had revealed that their life quality had a significant improvement compared with the life of preoperative (P < 0.05). Conclusion The whole pelvic floor reconstructive surgery with Gynecare Gynemeshsoft (T-prolift) is a Microtrauma Surgical with a safe operation, few complications reported and satisfied curement in the medium-term, it is worthy of clinical promotion
[Key words] Pelvic organ prolapse; Uterus prolapse; T-prolift; Gynecologic surgical operation
盆腔器官脱垂(pelvicorganprolapse，POP)是指由于各种原因引起的盆底支持组织薄弱，致使盆腔器官和邻近的阴道壁突入阴道或从阴道脱出的一组常见妇科疾病，是老年女性的常见病，严重影响着老年经产妇女的健康和生活质量[1]。2008年1月～2011年6月，笔者根据盆底重建理论，采用全盆底重建术治疗重度POP患者48例，获得了满意的临床效果，现总结报道如下：
1资料与方法
1.1一般资料
本组共48例，年龄48～76岁，平均59岁；均为绝经期患者，绝经年限1～28年，平均12年；孕次4～9次，平均4次；产次2～8次，平均3.4次；根据国际尿控协会制定的POP-Q分类分度[2]：阴道前后壁轻～重度脱垂合并穹隆或子宫Ⅲ～Ⅳ度脱垂34例，阴道前后壁重度脱垂合并穹隆或子宫Ⅱ度脱垂14例。其中合并高血压15例，冠心病9例，糖尿病15例，轻度脑梗死3例，便秘27例，术前压力性尿失禁33例。
1.2手术方法
手术在连续硬膜外麻醉下进行。暴露阴道前壁，于阴道膀胱间隙注入0.9%氯化钠溶液以充分水分离，沿前弯隆切口潜行分离双侧膀胱阴道间隙达耻骨降支后缘，触及耻骨后盆键弓筋膜后再分离到坐骨棘。将Prolift网片从中横断为前后两部分，前部分用于阴道前壁和前中翼；后部分用于阴道后壁和后翼。于阴道后壁注入0.9%氯化钠溶液以充分水分离，纵行切开阴道后壁 ......
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