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六臂网片全盆底重建术治疗重度盆腔器官脱垂患者的主观与客观评估:一项为期1年的回顾性研究

Subjective and Objective Evaluation of Total Pelvic Floor Reconstruction with Six-Arm Mesh in Patients with Severe Pelvic Organ Prolapse: A 1-Year Retrospective Study.

作者信息

Zhao Ying, Xia Zhi-Jun, Hu Qing, Qin Mei-Ying

机构信息

Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China.

出版信息

Ther Clin Risk Manag. 2020 Sep 14;16:861-870. doi: 10.2147/TCRM.S267832. eCollection 2020.

Abstract

PURPOSE

To investigate the effect of total pelvic floor reconstruction with a six-arm mesh in the treatment of pelvic organ prolapse.

PATIENTS AND METHODS

This is a retrospective observational cohort study. A total of 368 patients with pelvic organ prolapse underwent pelvic floor reconstruction surgery. Patients were categorized by the type of surgical mesh: 176 patients received a six-arm mesh and 192 patients received an anteroposterior approach mesh. The 1-year effect of the two groups was compared. The Pelvic Floor Distress Inventory Questionnaire (PFDI-20), Colorectal-Anal Distress Inventory (CRADI-8) and the Pelvic Organ Prolapse Quantitation (POP-Q) staging were used for evaluation. The incidence of complications was recorded. A cure standard was registered by a POP-Q score of grade I or below. A P value <0.05 indicates the difference is statistically significant.

RESULTS

There was no recurrence documented in the patients; the cure rate was 100% in both groups. After surgery, the length of the vagina in the six-arm mesh group was longer than that of the control group at 6 months and 12 months, respectively ( < 0.05). The six-arm mesh group had lower PFDI-20 and CRADI-8 scores after surgery than those of the control group at 6 and 12 months, respectively ( < 0.05). Pelvic floor and rectal dysfunction symptom improvement were superior in the six-arm mesh group compared with the control group. After surgery, the Female Sexual Function Inventory (FSFI) score of the six-arm mesh group was superior to that of the control group at 6 and 12 months, respectively ( < 0.05). The incidence of complications in the six-arm mesh group was lower than that of the control group ( < 0.05).

CONCLUSION

The total pelvic floor reconstruction using six-arm mesh has the same healing rate as anteroposterior approach mesh surgery, and it is better than traditional surgery in improving subjective symptoms and reducing postoperative complications.

摘要

目的

探讨采用六臂网片进行全盆底重建术治疗盆腔器官脱垂的效果。

患者与方法

这是一项回顾性观察队列研究。共有368例盆腔器官脱垂患者接受了盆底重建手术。患者按手术网片类型分类:176例患者接受六臂网片,192例患者接受前后入路网片。比较两组的1年疗效。采用盆底功能障碍性问卷(PFDI-20)、结直肠肛门功能障碍性问卷(CRADI-8)和盆腔器官脱垂定量分期(POP-Q)进行评估。记录并发症发生率。治愈标准为POP-Q评分I级及以下。P值<0.05表示差异具有统计学意义。

结果

患者均无复发记录;两组治愈率均为100%。术后,六臂网片组阴道长度在6个月和12个月时分别长于对照组(<0.05)。六臂网片组术后PFDI-20和CRADI-8评分在6个月和12个月时分别低于对照组(<0.05)。与对照组相比,六臂网片组盆底和直肠功能障碍症状改善更优。术后,六臂网片组女性性功能指数(FSFI)评分在6个月和12个月时分别优于对照组(<0.05)。六臂网片组并发症发生率低于对照组(<0.05)。

结论

采用六臂网片进行全盆底重建术与前后入路网片手术的治愈率相同,在改善主观症状和减少术后并发症方面优于传统手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6292/7500836/5e6cacda81e8/TCRM-16-861-g0001.jpg

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