全盆底网片悬吊术干预对盆腔脏器脱垂患者生活质量的短期影响

Short-term assessment for quality of life in patients with pelvic organ prolapse receiving total pelvic reconstruction

摘要:

目的 了解盆腔脏器脱垂(pelvic organ prolapse, POP)患者生活质量，评估全盆底网片悬吊手术对POP患者生活质量评分的短期干预效果。方法 将接受改良全盆底网片悬吊手术的68例患者作为研究组，接受prolift手术的37例患者为对照组；分别在术前、术后1个月时采用盆底生活质量评价量表(PFIQ-7)进行调查。描述2组患者的一般情况、手术前后生活质量评分，并对2组患者手术后生活质量评分改善程度进行对比分析。结果 对比研究组、对照组手术前后PFIQ-7生活质量调查表评分情况，术后生活质量评分明显改善（P＜0.05）。对2组间手术前后PFIQ-7生活质量评分改善程度（差值）进行对比： 虽然2组间的总评分相比差异无统计学意义(t＝0.761，P＝0.499），但在肠道或直肠症状的评分改善程度上，prolift术优于改良全盆底网片悬吊手术（t＝2.186，P＝0.031）；在阴道或盆腔症状评分改善上，改良全盆底网片悬吊手术优于prolift术（t＝-6.155，P＝0.000）。结论 改良全盆底网片悬吊术和prolift手术短期均能明显改善POP患者的生活质量。在肠道或直肠症状评分改善上，prolift手术优于改良全盆底网片悬吊手术；在阴道或盆腔症状评分改善上，改良全盆底网片悬吊手术具有明显的优势。

Abstract:

Objective To assess the short-term improvement of the quality of life in patients with pelvic organ prolapse(POP) after surgical intervention. Methods Sixty-eight patients with POP were treated with the modified total pelvic reconstruction(study group) and 37 POP patients were treated with prolift procedure(control group). The PFIQ-7 quality of life scores were assessed before and 1 month after intervention; the improvement of the quality of life was compared between two groups. Results There were significant differences in PFIQ-7 scores before and after intervention in both two groups(P<0.05). The improvement of the intestinal or rectal symptoms were more marked in control group than that in study group(t=2.186, P=0.031); while the improvement of vaginal or pelvic symptoms was more marked in study group than that in control group(t=-6.155, P=0.000). No significant difference was found between the two groups in the overall PFIQ-7 scores after operation(t=0.761, P=0.449). Conclusion Short-term assessment shows that both the modified total pelvic reconstruction and the prolift surgical operation can significantly improve the quality of life in POP patients with their own advantages.