陰道封閉術(shù)治療盆腔臟器脫垂的有效性及患者滿意度分析

牟秦巍 黨蓉芳 張永利 高立 李濤

【摘要】目的：探討陰道封閉術(shù)治療盆腔臟器脫垂的有效性及患者的滿意度。方法：選取2014年2月至2014年11月于我院行陰道全封閉術(shù)或陰道部分封閉術(shù)老年婦女患者30例為研究對(duì)象，平均年齡為70.58盆腔臟器脫垂量化評(píng)分系統(tǒng)（POP-Q）分期為III～I(xiàn)V期。在行陰道封閉手術(shù)前和手術(shù)后，利用泌尿生殖系統(tǒng)癥狀總表（UDI-6）和尿失禁影響問(wèn)卷（IIQ-7）評(píng)估患者的相關(guān)癥狀，并利用國(guó)際尿控協(xié)會(huì)標(biāo)準(zhǔn)對(duì)患者進(jìn)行尿動(dòng)力學(xué)評(píng)估。結(jié)果：30例患者中有22例行陰道部分封閉手術(shù)，8例行陰道全封閉術(shù)。其中，有7例患者行經(jīng)閉孔無(wú)張力尿道中段吊帶術(shù)。65.7%、26.8%和7.5%患者對(duì)該手術(shù)分別表示非常滿意、滿意和不滿意。手術(shù)后，所有患者的UDI-6和IIQ-7得分均發(fā)生顯著性改善（P>0.05）。未觀察到術(shù)后尿潴留，僅1例患者發(fā)生脫垂復(fù)發(fā)。結(jié)論：陰道封閉術(shù)是治療老年婦女患者盆腔臟器脫垂既安全又有效的一種手術(shù)方式，患者具有較高的主觀滿意率。

【關(guān)鍵詞】陰道封閉術(shù)；盆腔臟器脫垂；有效性；滿意度

【Abstract】Objectives： To investigate the efficacy and patient satisfaction of colpocleisis in treating pelvic organ prolapse. Methods： Thirty elderly female patients in our hospital undergoing total or partial colpocleisis operations from February 2014 to November 2014 were chosen in this study. The mean age was 70.583.41 years old， and the pelvic organ prolapse quantification （POP-Q） stage was III～I(xiàn)V stage. Pre- and post-operative symptoms were assessed using the urinary distress inventory （UDI-6） and the incontinence impact questionnaire （IIQ-7）， and the international continence society criteria were used for the urodynamic evaluation. Results： Among the total 30 patients， 22 patients underwent partial colpocleisis and another 8 underwent the total colpocleisis. Seven women underwent also a concomitant trans-obturator tension-free （TOT） procedure. Of the patients， 65.7%， 26.8% and 7.5% were ‘very satisfied， ‘satisfied and ‘not satisfied， respectively. After the colpocleisis operations， UDI-6 and IIQ-7 scores were improved significantly （P>0.05）. Post-operative urinary retention was not observed and prolapse recurred in one patient. Conclusion： Colpocleisis is a safe and effective surgical technique in treating the pelvic organ prolapse for the elderly female patients， with a high patient satisfaction rate.

【Key words】Colpocleisis； Pelvic organ prolapse； Efficacy； Satisfaction rate

【中圖分類(lèi)號(hào)】R713.4【文獻(xiàn)標(biāo)志碼】A

盆腔臟器脫垂（pelvic organ prolapse， POP）常因盆底支持組織缺損或松弛而引起，使得盆腔臟器脫離原先正常的解剖位置，包括子宮脫垂、陰道脫垂，同時(shí)伴有膀胱、直腸和小腸膨出。該病的臨床癥狀一般表現(xiàn)為慢性盆腔痛、走路或站立時(shí)有下墜感或壓迫感以及性交不適，影響患者正常生活[1，2]。如今，隨著人口老齡化現(xiàn)象的加劇，POP發(fā)病率呈上升趨勢(shì)。婦女健康研究顯示已婚婦女子宮脫垂發(fā)病率為0.04%～0.14%，51～60歲婦女發(fā)病率為0.33%，60歲以上為0.71%。而對(duì)……