人工合成网片盆底重建术后远期疗效及术后生活困扰的探讨

Long-term efficacy in female patients receiving pelvic floor reconstruction with synthetic mesh

摘要:

目的 探讨人工合成网片盆底重建术的远期疗效及术后生活困扰发生情况。方法 调查随访2007年1月至2018年1月因女性盆底功能障碍性疾病在同济大学附属同济医院妇科行人工合成网片盆底重建术的患者，将其按年龄分为中青年组、老年A组以及老年B组3组，回顾性分析其术后疗效及生活困扰发生情况。结果 各组术中出血量、手术时间、术后留置导尿时间差异无统计学意义（P＞0.05），术后36个月内有效率达94.53%；各组患者术后生活困扰发生率较术前明显降低（P<0.05），老年A组、B组评分与中青年组比较，差异有统计学意义（P<0.05、P<0.01），最常表现为排尿困扰，对性生活无影响。结论 人工合成网片适用于女性盆底重建术，且手术成功率高、术后复发率低，有利于减轻患者术后盆腔不适，患者术后生活质量困扰小。

Abstract:

Objective To assess the long-term efficacy in female patients receiving pelvic floor reconstruction with synthetic mesh. Methods A total of 335 female patients with pelvic floor defects，who underwent pelvic floor reconstruction with synthetic mesh in Department of Obstetrics and Gynecology of Tongji Hospital between January 2007 and January 2018, were followed up for 36 months. There were 92 patients aged<59 year (young-mid age group), 137 aged 6074 year(elderly group A) and 106 aged ≥75 year(elderly group B). The therapeutic efficacy was assessed with pelvic floor disability index-20, (PFDI-20) 36 months after surgery. Results There was no significant difference in intraoperative blood loss, operation time, and indwelling catheterization time among three age groups(P>0.05). The 36-month follow-up showed that the efficacy rate was 94.53%. The PFDI-20 score showed that compared with preoperative, the incidence of physical distress after surgery was significantly decreased in all groups, however（P<0.05）, the rates of physical distress after surgery in elderly groups A and B were significantly higher than that in young-mid age group(P<0.05 or P<0.01). Conclusion Pelvic floor reconstruction with synthetic mesh is effective for women with pelvic floor defect. The long-term follow-up shows that the recurrence rate is low and physical distress is fewer.