贵州医科大学学报

2019, v.44;No.228(09) 1088-1092

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不同手术方式对子宫脱垂患者的临床疗效和术后生活质量的影响
Clinical Effect of Different Surgical Methods on Patients with Uterine Prolapse and Postoperative Quality of Life

叶文凤;阮秋香;李沁;史丽娟;阮紫珍;
YE Wenfeng;RUAN Qiuxiang;LI Qin;SHI Lijuan;RUAN Zizhen;The First People's Hospital of Changzhou;Changzhou De'an Hospital;Shangluo Maternal and Child Health Care Hospital;

摘要(Abstract):

目的:探讨经阴道骶棘韧带固定术(SSLF)与盆底重建术(PFR)对子宫脱垂患者的临床疗效及术后生活质量的影响。方法:选择子宫脱垂患者25例行SSLF作为研究组,35例患者行PFR作为对照组,收集两组患者住院期间的手术相关指标(手术时间、术中出血量、术后发热、解剖恢复、术后自主排尿时间、住院时间、手术费用等)及术后随访调查资料(复发病例数、术后大腿及臀部疼痛、新发尿失禁、便秘、阴道长度、性交疼痛及性生活满意度),采用盆底功能障碍问卷(PFDI-20)评价两组患者手术前后的生活质量。结果:研究组患者手术时间、术后自主排尿时间、平均住院日和手术费用均明显少于对照组,差异均有高度统计学意义(P<0.001);术后两组患者PFDI-20各分量表得分和总分均较术前降低(P<0.05),术后两组患者PEDI-20分量表UDI-6评分和PFDI-20总分差异有统计学意义(P<0.05);手术后随访资料结果显示,两组患者的复发率、会阴及臀部疼痛率、新发尿失禁发生率、便秘发生率、性交疼痛率及性生活满意度比例比较,差异均无统计学意义(P>0.05)。结论:SSLF相对于PFR治疗子宫脱垂患者的优点是手术时间较短、术后自主排尿时间较早、平均住院日较少和手术费用较低,能提高患者术后的生活质量,且可以达到同样的远期效果,值得临床推广。
Objective: To investigate the efficacy of pelvic floor reconstruction(PFR) and vaginal sacrospinous ligament fixation(SSLF) on patients with uterine prolapse and postoperative quality of life. Methods: Uterine prolapse patients were divided into research group(n=25) and control group(n=35). The research group underwent vaginal sacrospinous ligament fixation(SSLF), the control group underwent pelvic floor reconstruction(PFR). Collecting surgical indices of both groups during hospitalization(surgery time, intraoperative blood loss, postoperative pyrexia, anatomy recovery, postoperative independent micturition time, hospitalization time, surgery cost and so on), and follow-up interview data(recurrence case number, postoperative thigh and buttock pain, emerging uroclepsia, constipation, length of remaining unprolapse vaginal, dyspareunia and satisfaction with sexual intercourse), adopting PFDI-20 to evaluate postoperative quality of life of both groups. Results: Research group patients showed less surgery time, postoperative independent micturition time, hospitalization time and surgery cost than control group, difference was highly statistically significant(P<0.001). Postoperative PFDI-20 subscale scores and total scores were lowered than before surgery, difference was statistically significant(P<0.005); after treatment, there were statistically significant differences in UDI-6 scores and total scores between the two groups(P<0.05). There was no significant difference in the recurrence rate, perineal and buttock pain rate, emerging uroclepsia occurrence rate, constipation occurrence rate, dyspareunia rate and satisfaction rate with sexual intercourse between the two groups from follow-up date(P>0.05). Conclusion: Compared with PFR surgery, SSLF has the advantages of less operation time, early postoperative independent micturition, less average hospital stay and lower operation cost, which can improve the quality of life and achieve the long-term effect of PFR surgery and is worthy of clinical promotion.

关键词(KeyWords): 子宫脱垂;生活质量;经阴道骶棘韧带固定术;盆底重建术;盆底功能障碍问卷
uterine prolapse;quality of life;vaginal sacrospinous ligament fixation;pelvic floor;pelvic floor dysfunction questionnaire

Abstract:

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基金项目(Foundation): 常州市卫生计生委重大科技项目(ZD201702)

作者(Author): 叶文凤;阮秋香;李沁;史丽娟;阮紫珍;
YE Wenfeng;RUAN Qiuxiang;LI Qin;SHI Lijuan;RUAN Zizhen;The First People's Hospital of Changzhou;Changzhou De'an Hospital;Shangluo Maternal and Child Health Care Hospital;

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DOI: 10.19367/j.cnki.1000-2707.2019.09.020

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