86例前盆底悬吊术及阴道后壁桥式缝合术临床观察.doc

86例前盆底悬吊术及阴道后壁桥式缝合术临床观察[摘要] 目的 探讨86例前盆底悬吊术及阴道后壁桥式缝合术的疗效及并发症的处理。方法 选取2006年1月～2008年12月在浙江省宁波市妇女儿童医院妇产科行前盆底重建术及阴道后壁桥式缝合术86例（其中28例合并压力性尿失禁同时行尿道中段悬吊术）的资料统计，分析其临床效果及并发症的处理情况。结果 86例行前盆底悬吊术及阴道后壁桥式缝合术患者，15例同时行阴式子宫全切术，15例患者术中出血量大于300mL。术中无膀胱损伤、直肠损伤等并发症。术后2个月首次随访率78%，按照子宫脱垂Ⅰ度以下标准治愈率达 100%。远期不定期随访 62例，随访率72%，1例阴道后壁脱垂Ⅲ度患者术后3个月出现阴道后壁膨出Ⅲ度再次入院行后盆底重建， 2例（1.0%）出现移植物侵蚀，1例出现阴道紧缩感。3例出现压力性尿失禁，其中1例术后4个月再次入院行尿道中段悬吊术，2例术后6个月再次随访后好转。结论 前盆底悬吊术及阴道后壁桥式缝合术治疗盆腔脏器脱垂近期效果显著，远期效果尚有待进一步随访。术后有一定的并发症，选择手术方式时应个体化治疗。 [关键词] 女性盆底功能障碍性疾病 ； 盆底重建术 ； 手术并发症 [中图分类号] R713 [文献标识码] B [文章编号]1673-9701（2011）32-151-02 Pelvic Floor Anterior Reconstructive Surgery and Vaginal Posterior Bridge Repair :A Clinical Observation of 86 Cases LI Xin JIANG Bengui Department of Obstetrics and Gynecology, Ningbo City Women and Children Hospital，Ningbo 315000，China [Abstract] Objective To investigate the effects and the complication of pelvic floor anterior reconstructive surgery and vaginal posterior bridge repair in 86 cases. Methods Eighty-six cases with pelvic organ prolapse of Ningbo Women and Chindren Hospital from Jan 2006 to Dec 2008 were operated with pelvic floor anterior reconstructive surgery and vaginal posterior bridge repair（28 cases among the total with stress urinary incontinence were operated tension free vaginal tape through obturator）.The effects and complications of the opertion were retrospectively analyzed. Results Fifteen cases among the tatal were operated vaginal hysterectomy,15 cases hemorrhage were larger than 300mL.There had no intraoperative complications occurred.The rate first time follow-up after operation 2 months later was 78%.The patients were Uterus Ⅰstage prolapse after operation,the cases were cured. The rate long-term follow-up after operation was 72%.1 case was operated once again 3 months later because of Ⅲstage vaginal posterior prolapse, 2 cases （1.0%） mesh erosion occurred.1 tightness occurred.3 cases stress urinary incontinence in which 1 case was operated tension free v