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目的比较传统修补、Prolift盆底重建系统和Gynemesh聚丙烯补片在全盆底重建术中的应用情况。方法回顾分析2009年3月至2011年3月间第二军医大学长海医院收治的40例盆腔脏器脱垂行全盆底重建术的患者资料。采用传统修补15例,Prolift盆底重建10例,Gynemesh聚丙烯补片行童式全盆底重建术15例。比较3组患者的一般资料、围手术期和随访情况,并进行统计学分析。结果 3组患者的体质量指数、平均年龄、绝经年龄和孕次比较,差异均无统计学意义(P>0.05)。3组患者阴道前壁脱垂、子宫脱垂和阴道后壁脱垂的程度差异无统计学意义(P>0.05)。3组患者术中出血量、最高体温、尿管留置天数、术后残余尿、手术时间和住院时间比较,差异无统计学意义(P>0.05)。Prolift组随访率100%,平均随访时间(5.8±2.0)个月,1例患者补片侵蚀,1例患者出现轻度张力性尿失禁;Gynemesh组随访率93.3%,平均随访时间(9.1±2.0)个月,1例患者术后出现乳糜样腹水,1例前壁复发(POP-QⅡ期);传统修补组随访率100%,平均随访时间(9.1±5.0)个月,阴道前、后壁复发各1例(POP-QⅡ期)。结论传统修补、Prolift和Gynemesh补片均可用于全盆底重建,手术均安全可行。在近期疗效和并发症方面,3组间无明显差异。
Objective To compare the application of traditional repair, Prolift pelvic floor reconstruction system and Gynemesh polypropylene patch in pelvic floor reconstruction. Methods The data of 40 patients with pelvic organ prolapse undergoing pelvic floor reconstruction admitted to Changhai Hospital of Second Military Medical University from March 2009 to March 2011 were retrospectively analyzed. Traditional repair in 15 cases, Prolift pelvic floor reconstruction in 10 cases, Gynemesh polypropylene patch line pelvic floor reconstruction in 15 cases. The general data, perioperative period and follow-up of the three groups were compared and statistically analyzed. Results There were no significant differences in body mass index, mean age, menopausal age and gestational age between the three groups (P> 0.05). There was no significant difference in the degree of anterior vaginal prolapse, uterine prolapse and vaginal posterior wall prolapse in the three groups (P> 0.05). There was no significant difference in the amount of blood loss, the highest temperature, the number of catheter indwelling days, postoperative residual urine, operation time and hospital stay in the three groups (P> 0.05). The follow-up rate was 100% in Prolift group and the average follow-up time was (5.8 ± 2.0) months. One patient had patch erosion and one patient had mild tension incontinence. The follow-up rate was 93.3% in Gynemesh group and 9.1 ± 2.0 ) Months, one patient presented with chylous ascites and one case of anterior wall recurrence (POP-QⅡ). The follow-up rate was 100% in the conventional repair group, with an average follow-up time of 9.1 ± 5.0 months. One case of recurrence (POP-QⅡ). Conclusion The traditional repair, Prolift and Gynemesh patch can be used for pelvic floor reconstruction, the operation is safe and feasible. In the short term efficacy and complications, there was no significant difference between the three groups.