Chao Fay L, Rosamilia Anna, Dwyer Peter L, Polyakov Alex, Schierlitz Lore, Agnew Gerard
Pelvic Floor Unit Southern Health, Monash Medical Centre, Moorabbin Campus, Melbourne, Victoria 3165, Australia.
Int Urogynecol J. 2012 Apr;23(4):417-22. doi: 10.1007/s00192-011-1656-0. Epub 2012 Jan 26.
This study aims to compare pre-operative Pelvic Organ Prolapse Quantification (POP-Q) point C with and without cervical traction to that obtained intra-operatively in women undergoing pelvic organ prolapse surgery and to assess acceptability of examination with cervical traction without anaesthesia.
Eighty-one women were randomised to having pre-operative examination with or without cervical traction to measure point C. Visual analogue scale (VAS) pain scores were recorded for each pre-operative examination. Comparisons were made between pre-operative and intra-operative findings.
The mean difference between pre-operative and intra-operative point C in the non-traction group was statistically higher than in the traction group (3.2 vs 1.6 cm, p = 0.0001). The level of agreement between pre-operative point C measurement with traction and intra-operative point C measurement was better than pre-operative point C measurement without traction and intra-operative point C measurement on Bland and Altman plots. Women having cervical traction reported significantly greater pain score on the VAS (3.4 vs. 1.2, p < 0.0001).
Compared to routine pre-operative examination with Valsalva and cough manoeuvres only, pre-operative examination with cervical traction had better agreement with intra-operative point C findings. Although women reported greater pain score when examined with cervical traction, it was still a tolerable and acceptable examination without anaesthesia.
本研究旨在比较盆腔器官脱垂手术女性患者术前在有或无宫颈牵引情况下的盆腔器官脱垂定量（POP-Q）C点，与术中所获C点的情况，并评估无麻醉下宫颈牵引检查的可接受性。
81名女性被随机分为两组，一组在术前进行有宫颈牵引的检查以测量C点，另一组则进行无宫颈牵引的检查。每次术前检查均记录视觉模拟量表（VAS）疼痛评分。对术前和术中的结果进行比较。
非牵引组术前与术中C点的平均差异在统计学上高于牵引组（3.2 vs 1.6 cm，p = 0.0001）。在布兰德-奥特曼图上，术前有牵引时C点测量值与术中C点测量值之间的一致性水平，优于术前无牵引时C点测量值与术中C点测量值之间的一致性。进行宫颈牵引的女性在VAS上报告的疼痛评分显著更高（3.4 vs. 1.2，p < 0.0001）。
与仅采用瓦尔萨尔瓦动作和咳嗽动作的常规术前检查相比，术前进行宫颈牵引检查与术中C点的检查结果一致性更好。尽管女性在进行宫颈牵引检查时报告的疼痛评分更高，但这仍是一项在无麻醉情况下可耐受且可接受的检查。
