期刊文献+

老年重度盆腔器官脱垂患者阴道完全封闭术与阴道部分封闭术围手术期情况比较

Comparison of periOperative conditions between total and partial colpocleisis for elderly patients suffered from severe pelvic organ prolapse
收藏 分享 导出
摘要 目的探讨阴道完全封闭术与阴道部分封闭术治疗老年重度盆腔器官脱垂(POP)患者的围手术期情况。方法选取2014年1月至2017年10月采取阴道完全封闭术或阴道部分封闭术治疗的老年重度POP患者286例,年龄(76.0±5.1)岁(范围:60~90岁),其中220例(76.9%,220/286)伴有1种以上的内科合并症。分析阴道完全封闭术和阴道部分封闭术患者的围手术期指标,包括:手术时间、术中出血量、术后住院时间、围手术期并发症、术前排尿困难症状的术后改善情况。结果286例患者中,行阴道完全封闭术172例(60.1%),阴道部分封闭术114例(39.9%);有48例(16.8%,48/286)合并压力性尿失禁的患者同时行抗尿失禁手术;术前存在排尿困难的患者129例(45.1%,129/286)。286例患者的手术时间为(67±22)min,术中出血量为(52±57)ml,术后住院时间为(5.9±1.9)d(范围:2~16 d)。286例患者发生围手术期并发症25例(8.7%,25/286),包括术中膀胱损伤1例、术后盆腔血肿3例、肠梗阻1例、心房颤动5例、术后病率3.5%(10/286)、肺栓塞3例、下肢静脉血栓1例、尿潴留经保留尿管无效后电刺激治疗1例。阴道完全封闭术与阴道部分封闭术患者的手术时间分别为(67±22)和(68±20)min,术中出血量分别为(58±62)和(41±45)ml,住院时间分别为(5.9±1.9)和(6.0±1.8)d,围手术期并发症发生率分别为8.1%(14/172)和9.6%(11/114),术前存在排尿困难的患者术后自主排尿后测残余尿量分别为(35±43)和(34±41)ml;以上指标分别比较,差异均无统计学意义(P均>0.05)。结论阴道封闭术对于治疗高龄体弱、无性生活要求、不能耐受盆底重建手术的老年患者,是安全、出血少、恢复快的术式。阴道完全封闭术与阴道部分封闭术的围手术期情况无显著区别,术式的选择要根据有无子宫恶性肿瘤可能、患者年龄、意愿和全身状况等因素综合决定。 ObjectiveTo study perioperative period conditions of total and partial colpocleisis with severe pelvic organ prolapse (POP) in elderly patients.MethodsFrom Jan. 2014 to Oct. 2017 286 severe POP elderly patients underwent total or partial colpocleisis. The mean age was (76.0±5.1) years (60-90 years) . Of which, 220 patients (76.9%, 220/286) presented more than one kind of medical disease. The operative time, intraoperative blood loss, hospital stay after surgery, postoperative complications, preoperative urinary dysuria symptoms of total and partial colpocleisis in treatment of 286 patients were analyzed.ResultsIn 286 patients, 172 patients (60.1%) underwent total colpocleisis and 114 patients (39.9%) underwent partial colpocleisis. Totally 48 patients (16.8%) in 286 patients underwent anti-urinary incontinence procedure. The mean operating time of 286 patients was (67±22) minutes,the mean blood loss was (52± 57) ml, the mean hospital stay after surgery was (5.9±1.9) days (2-16 days) . The rate of postoperative complications was 8.7% (25/286) . Those complications including 1 case of bladder injury during operation, 3 cases of postoperative pelvic hematoma, 1 case of intestinal obstruction, 5 cases of atrial fibrillation, 10 cases of postoperative morbidity, 3 cases of pulmonary embolism, 1 case of lower limb thrombosis, 1 case of urinary retention underwent electrical stimulation treatment because of ineffective application of urinary retention catheter. The mean operating time was (67±22) minutes in total colpocleisis and (68±20) minutes in partial colpocleisis (P>0.05) , the mean blood loss was (58±62) ml in total colpocleisis and (41±45) ml in partial colpocleisis (P>0.05) , the mean hospital stay after surgery was (5.9±1.9) days in total colpocleisis and (6.0±1.8) days in partial colpocleisis (P>0.05) , the rate of post operative complications was 8.1%(14/172) in total colpocleisis and 9.6% (11/114) in partial colpocleisis (P>0.05) , respectively;those four of comparisons showed no significant diffe
作者 鞠蕊 杨欣 孙秀丽 李晓伟 赵桂君 汪红英 王建六 Ju Rui;Yang Xin;Sun Xiuli;Li Xiaowei;Zhao Guijun;Wang Hongying;Wang Jianliu(Departmemt of Gynecology,Peking University People's Hospital,Beifing 100044,China;Departmemt of Obstetrics and Gynecology,Beijing Chuiyangliu Hospital,Beijing 100022,China)
出处 《中华妇产科杂志》 CAS CSCD 北大核心 2019年第1期33-37,共5页 Chinese Journal of Obstetrics and Gynecology
关键词 盆腔器官脱垂 妇科外科手术 围手术期 阴道封闭术 Pelvic organ prolapse Gynecologic surgical procedures Perioperative period Colpocleisis
作者简介 通信作者:王建六,Email:wangjianliu1203@163.com.
  • 相关文献

参考文献9

二级参考文献120

  • 1王建六,曹冬,张晓红,王世军,李小平,吴俊改,陈捷.北京郊区女性尿失禁及盆腔脏器脱垂发病情况及其对生活质量影响的抽样调查[J].中国妇产科临床杂志,2007,8(1):5-9. 被引量:77
  • 2Hoffman MS,Cardosi RJ,Lockhart J,et al.Vaginectomy with pelvic herniorrhaphy for prolapse.Am J Obstet Gynecol,2003Aug,189:364-371. 被引量:1
  • 3Fitzgerald MP,Richter HE,Bradley CS,et al.Pelvic support,pelvic symptoms,and patient satisfaction after colpocleisis.Int Urogynecol J,2008,19:1603-1609. 被引量:1
  • 4DeLancey JOL,Morley GW.Total colpocleisis for vaginal eversion.Am J Obstet Gynecol,1997,176:1228-1235. 被引量:1
  • 5Glavind K,Kempf L.Colpectomy or LeFort colpocleisis:a good option in selected elderly patients.Int Urogynecol J,2005,16:48-51. 被引量:1
  • 6de Leval J,Waltregny D.New surgical technique for treatment of stress urinary incontinence TVT-0 bturator; new developments and results.Surg Technol Int,2005,14:212-221. 被引量:1
  • 7Hullfish KL,Bovbjerg VE,Steers WD.Colpocleisis for pelvic organ prolapse.Ppatient goals,quality of life,and satisfaction.Obstet Gynecol,2007,110(2 Pt 1):341-345. 被引量:1
  • 8Shah AD,Kohli N,Rajan SS,et al.The age distribution,rates,and types of surgery for pelvic organ prolapse in the USA.Int Urogynecol J,2008,19:421-428. 被引量:1
  • 9Menard JP,Mulfinger C,Estrade JP,et al.Pelvic organ prolapse surgery in women aged more than 70 years:a literature review.Gynecol Obstet Fertil,2008,36:67-73. 被引量:1
  • 10Goode PS,Fitzgerald MP,Richter HE,et al.Enhancing participation of older women in surgical trials.J Am Coll Surg,2008,207:303-311. 被引量:1

共引文献94

投稿分析

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈