曾莹，周利梅，高静，夏良斌

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盆底重建患者术前尿动力学结果的初步分析

曾莹，周利梅，高静，夏良斌

目的：总结盆底重建患者的尿动力学特点，以尿动力学为切入点结合PFIQ-7问卷探讨盆底重建术与抗压力性尿失禁（SUI）手术的关系。方法：回顾性分析2012年7月—2014年1月因盆腔器官脱垂（POP）仅行Prolift全盆底重建术129例患者的临床资料，根据是否合并SUI分为POP+SUI组（26例）和POP组（103例），比较2组的尿动力学检查结果及不同年龄段的情况，同时对采用PFIQ-7问卷调查后60例患者（POP+SUI组13例，POP组47例）术前和术后6个月生活质量影响评分进行比较。结果：①POP+SUI组Aa的评分为（2.133±0.417）cm，高于POP组的（1.417±0.612）cm，差异有统计学意义（P=0.027）。②2组尿动力学检查中仅尿道功能的最大尿道压均值和最大尿道闭合压异常比例差异有统计学意义（P=0.032；P=0.029）。③2组患者各自术前与术后PFIQ-7评分总分差异均有统计学意义（P=0.021；P=0.047），术后2组各项PFIQ-7评分差异均无统计学意义（P＞0.05）。结论：建议在盆底重建术前行尿动力学检查，盆底重建同时行抗SUI手术需谨慎，需结合患者的年龄、尿动力学结果及患者的临床症状综合判断。

尿动力学；尿失禁，压力性；骨盆底；修复外科手术

【Abstract】Objective:Summarize the characteristics of urodynamics in patients with pelvic reconstructive surgery，and with PFIQ-7 questionnaire research，to discuss the relationship between pelvic reconstructive surgery and the stress urinary incontinence（SUI）surgery.Methods：Retrospectively analyzed the 129 patients who were done Prolift reconstructive surgery only from July 2012 to January 2014，all the people were divided into pelvic organ prolapse（POP）+SUI group（26 cases）and POP group（103 cases），according to whether they were suffering SUI or not，compared the urodynamics results and urethral function in each age brackets between the two groups.PFIQ-7 questionnaires were then used to survey the last 60 patients（POP+SUI group：13 cases；POP group：47 cases）with pelvic reconstructive surgery before surgery and six months after surgery.Results：Score of Aa was higher in POP+SUI group［（2.133±0.417）cm］than POP group［（1.417±0.612）cm］，significant differences were detected between the two groups（P=0.027）.No significant differences were detected in urodynamic results except maximum urethral pressure and maximum urethral closure pressure（P=0.032；P=0.029）.Significant differences were detected in PFIQ-7 questionnaire total scores before and after surgery in the two groups respectively（P=0.021；P=0.047），no significant differences were found between the two groups after surgery in PFIQ-7 questionnaires（P＞0.05）.Conclusions：Urodynamic was suggested before pelvic reconstructive surgery，and SUI prevention should be cautious in the pelvic reconstructive surgeries，ages，urodynamiacs and clinical materials were need to take into consideration.

【Keywords】Urodynamics；Urinary incontinence，stress；Pelvic floor；Reconstructive surgery

（J Int Obstet Gynecol，2015，42：432-436）

随着人口老龄化及人们对生活质量要求的提高，盆底功能障碍性疾病引起了越来越多的关注。盆底功能障碍性疾病主要包括盆腔器官脱垂（pelvic organ prolapse，POP）和尿失禁（urinary incontinence），UI中又以压力性尿失禁（stress urinary incontinence，SUI）为主。POP和SUI均为严重影响身心健康的中老年妇女常见疾病。Ⅱ度以上的POP和中重度的SUI都以手术治疗为主，目前具有代表性的术式分别为盆底重建术和尿道中段悬吊术。……