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目的观察阴式全子宫切除术(the total vaginal hysterectomy,TVH)联合阴道前后壁修补术治疗盆腔脏器脱垂(pelvic organ prolapse,POP)的临床效果。方法选择2013年1月—2015年12月就诊的POP患者72例,随机分为对照组与观察组各36例。对照组给予AH加阴道前后壁修补术,观察组给予TVH联合阴道前后壁修补术。统计两组手术时间、术后排气时间、失血量、术后进食时间及住院时间;分别于术后1、3个月及1年比较两组疗效;统计两组术后1、3个月及1年复发率。计量资料比较采用t检验,计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果两组手术时间比较差异无统计学意义(P>0.05),观察组术后排气时间、失血量、术后进食时间及住院时间[(2.31±0.41)d、(122.47±8.59)、(2.57±0.40)ml、(5.46±1.12)d]低于对照组[(3.75±0.35)d、(171.34±10.21)、(3.94±0.63)ml、(9.14±1.50)d],比较差异有统计学意义(均P<0.05)。对照组术后1个月、3个月及1年总有效率分别为61.11%(22/36)、63.89%(23/36)、47.22%(17/36);观察组分别为88.89%(32/36)、94.44%(34/36)、77.78%(28/36)。术后1个月、3个月及1年观察组总有效率均高于对照组(均P<0.05)。两组术后1年内复发情况比较差异有统计学意义(χ~2=5.791,P<0.05)。结论 TVH联合阴道前后壁修补术治疗POP具有较好的临床疗效,快速、有效、复发率低及安全性好。
Objective To observe the clinical effect of vaginal hysterectomy (TVH) combined with vaginal anterior and posterior wall repair on pelvic organ prolapse (POP). Methods Seventy-two POP patients from January 2013 to December 2015 were randomly divided into control group and observation group with 36 cases each. The control group was given AH plus vaginal anterior and posterior wall repair, the observation group was given TVH combined vaginal anterior and posterior wall repair. The operation time, postoperative exhaust time, blood loss, postoperative eating time and hospital stay were recorded. The curative effect was compared between the two groups at 1, 3 months and 1 year after operation. And 1 year recurrence rate. Measurement data were compared using t test, count data were compared using χ ~ 2 test, P <0.05 for the difference was statistically significant. Results There was no significant difference in operative time between the two groups (P> 0.05). The postoperative exhaust time, blood loss, postoperative eating time and hospital stay [(2.31 ± 0.41) d, (122.47 ± 8.59, 2.57 ± 0.40) ml, (5.46 ± 1.12) d] were lower than that of the control group [(3.75 ± 0.35) d, (171.34 ± 10.21), (3.94 ± 0.63) ml, Significance (both P <0.05). The total effective rates of one month, three months and one year in the control group were 61.11% (22/36), 63.89% (23/36) and 47.22% (17/36), respectively. The observation group were 88.89% 32/36), 94.44% (34/36), 77.78% (28/36). The total effective rate of the observation group at 1 month, 3 months and 1 year after operation was significantly higher than that of the control group (all P <0.05). There was significant difference in recurrence between the two groups within one year after surgery (χ ~ 2 = 5.791, P <0.05). Conclusion TVH combined vaginal anterior and posterior wall repair of POP has a good clinical efficacy, fast, effective, low recurrence rate and good safety.