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目的:评价19例聚丙烯网片盆底重建术后(3~8年)阴道网片暴露情况及其危险因素分析。方法:对116例经盆腔脏器脱垂评分(pelvic organ prolapse quantitation,POP-Q)诊断为Ⅱ度及以上的盆腔脏器脱垂患者,行经阴道网片(聚丙烯材料)盆底重建术,分为前盆底、后盆底、全盆底重建术。术后检查阴道内有无网片组织暴露,且分析网片暴露的危险因素。结果:116例患者中19例出现网片暴露(直径≥0.2 cm),暴露率为16.4%(19/116)。网片暴露组与非暴露组相比,其年龄、体质指数(BMI)、产次、是否同时行阴式子宫切除术、被动吸烟、高血压、糖尿病等均无统计学差异(P>0.05);与手术方式(前、后、全盆底重建术)相关(P<0.05),以前盆底重建术网片暴露发生率最低,为12.7%(13/102)。结论:聚丙烯网片盆底重建术其网片暴露的发生与年龄、BMI、产次、阴式子宫切除术、被动吸烟、高血压、糖尿病无关,其手术方式可能是唯一的危险因素。
OBJECTIVE: To evaluate the risk factors of vaginal mesh exposure in 19 cases of polypropylene mesh pelvic floor reconstruction (3-8 years). Methods: One hundred and sixty-one pelvic organ prolapse quantitation (POP-Q) patients with pelvic organ prolapse of grade Ⅱ and above underwent pelvic floor reconstruction via vaginal mesh (polypropylene) Divided into pelvic floor, pelvic floor, pelvic floor reconstruction. Postoperative vaginal examination of mesh tissue exposure, and analysis of mesh exposure risk factors. Results: In 116 patients, there were 19 cases of mesh exposure (diameter ≥0.2 cm), the exposure rate was 16.4% (19/116). Compared with non-exposed group, there was no significant difference in age, body mass index (BMI), parity, vaginal hysterectomy, passive smoking, hypertension and diabetes mellitus (P> 0.05) (P <0.05). The incidence of pelvic floor reconstruction was the lowest before operation (12.7%, 13/102). CONCLUSION: The exposure of mesh in polypropylene mesh pelvic floor reconstruction has nothing to do with age, BMI, parity, vaginal hysterectomy, passive smoking, hypertension and diabetes. The surgical approach may be the only risk factor.