Barber Matthew D, Walters Mark D, Cundiff Geoffrey W
The Cleveland Clinic Foundation, Cleveland, OH, USA.
Am J Obstet Gynecol. 2006 May;194(5):1492-8. doi: 10.1016/j.ajog.2006.01.076.
This study was undertaken to evaluate the responsiveness of the Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ) in women with pelvic organ prolapse undergoing surgical and nonsurgical management.
The responsiveness of the prolapse, urinary and colorectal scales of the PFDI and PFIQ were assessed in 2 independent populations: (1) 42 women with stage II or greater prolapse enrolled in an ongoing multicenter randomized trial comparing 2 different pessaries (Pessary group) and (2) 64 women with stage III or greater prolapse who underwent vaginal reconstructive surgery (Surgery group). All subjects completed the PFDI and PFIQ at baseline and again either 3 months (Pessary group) or 6 months (Surgery group) after initiation of treatment. Responsiveness was assessed with standardized response mean (SRM), effect size (ES), and the paired t test.
In the Pessary group, there was a significant improvement in the prolapse and urinary scales of the PFDI, with each demonstrating moderate responsiveness (prolapse: SRM 0.69, ES 0.68; urinary: SRM 0.57, ES: 0.50, P < .001 for each). The colorectal scale of the PFDI and each of the 3 scales of the PFIQ demonstrated no significant change in scores with pessary use. In the Surgery group, there was a significant improvement in the prolapse, urinary, and colorectal scales of both the PFDI and PFIQ (P < .01 for each). The prolapse and urinary scales of the PFDI demonstrated excellent responsiveness with SRM and ES 1.20 or greater for the prolapse scale and equal to1.05 for the urinary scales. The colorectal scale of the PFDI and the urinary and prolapse scales of the PFIQ demonstrated moderate responsiveness (SRM 0.61-0.70 and ES 0.56-0.60) after surgery. Subjects who had a recurrence of their prolapse develop after surgery (6%) had significantly less improvement in the prolapse scale of the PFDI than those who did not. After controlling for preoperative prolapse stage and baseline quality of life scores, subjects in the Surgery group had significantly greater improvement in each of the scales of the PFDI and the prolapse and urinary scales of the PFIQ than did the Pessary group (P < .05 for each).
The PFDI and PFIQ are responsive to change in women undergoing surgical and nonsurgical treatment for pelvic organ prolapse. The PFDI is more responsive than the PFIQ.
本研究旨在评估盆腔器官脱垂女性在接受手术和非手术治疗时盆底功能障碍量表（PFDI）和盆底功能影响问卷（PFIQ）的反应性。
在2个独立人群中评估PFDI和PFIQ的脱垂、泌尿和结直肠量表的反应性：（1）42例II期或更严重脱垂的女性参与一项正在进行的多中心随机试验，比较2种不同的子宫托（子宫托组）；（2）64例III期或更严重脱垂的女性接受阴道重建手术（手术组）。所有受试者在基线时完成PFDI和PFIQ，在开始治疗后3个月（子宫托组）或6个月（手术组）再次完成。用标准化反应均值（SRM）、效应大小（ES）和配对t检验评估反应性。
在子宫托组，PFDI的脱垂和泌尿量表有显著改善，各显示出中度反应性（脱垂：SRM 0.69，ES 0.68；泌尿：SRM 0.57，ES 0.50，各P <.001）。PFDI的结直肠量表和PFIQ的3个量表在使用子宫托后得分均无显著变化。在手术组，PFDI和PFIQ的脱垂、泌尿和结直肠量表均有显著改善（各P <.01）。PFDI的脱垂和泌尿量表显示出极好的反应性，脱垂量表的SRM和ES为1.20或更高，泌尿量表为1.05。PFDI的结直肠量表以及PFIQ的泌尿和脱垂量表在术后显示出中度反应性（SRM 0.61 - 0.70，ES 0.56 - 0.60）。术后发生脱垂复发的受试者（6%）在PFDI脱垂量表上的改善明显低于未复发者。在控制术前脱垂分期和基线生活质量评分后，手术组受试者在PFDI各量表以及PFIQ的脱垂和泌尿量表上的改善均显著大于子宫托组（各P <.05）。
PFDI和PFIQ对盆腔器官脱垂接受手术和非手术治疗的女性的变化有反应。PFDI比PFIQ反应性更强。
