牟秦巍 党蓉芳 张永利 高立 李涛

【摘要】目的：探讨阴道封闭术治疗盆腔脏器脱垂的有效性及患者的满意度。方法：选取2014年2月至2014年11月于我院行阴道全封闭术或阴道部分封闭术老年妇女患者30例为研究对象，平均年龄为70.58盆腔脏器脱垂量化评分系统（POP-Q）分期为III～IV期。在行阴道封闭手术前和手术后，利用泌尿生殖系统症状总表（UDI-6）和尿失禁影响问卷（IIQ-7）评估患者的相关症状，并利用国际尿控协会标准对患者进行尿动力学评估。结果：30例患者中有22例行阴道部分封闭手术，8例行阴道全封闭术。其中，有7例患者行经闭孔无张力尿道中段吊带术。65.7%、26.8%和7.5%患者对该手术分别表示非常满意、满意和不满意。手术后，所有患者的UDI-6和IIQ-7得分均发生显著性改善（P>0.05）。未观察到术后尿潴留，仅1例患者发生脱垂复发。结论：阴道封闭术是治疗老年妇女患者盆腔脏器脱垂既安全又有效的一种手术方式，患者具有较高的主观满意率。

【关键词】阴道封闭术；盆腔脏器脱垂；有效性；满意度

【Abstract】Objectives： To investigate the efficacy and patient satisfaction of colpocleisis in treating pelvic organ prolapse. Methods： Thirty elderly female patients in our hospital undergoing total or partial colpocleisis operations from February 2014 to November 2014 were chosen in this study. The mean age was 70.583.41 years old， and the pelvic organ prolapse quantification （POP-Q） stage was III～IV stage. Pre- and post-operative symptoms were assessed using the urinary distress inventory （UDI-6） and the incontinence impact questionnaire （IIQ-7）， and the international continence society criteria were used for the urodynamic evaluation. Results： Among the total 30 patients， 22 patients underwent partial colpocleisis and another 8 underwent the total colpocleisis. Seven women underwent also a concomitant trans-obturator tension-free （TOT） procedure. Of the patients， 65.7%， 26.8% and 7.5% were ‘very satisfied， ‘satisfied and ‘not satisfied， respectively. After the colpocleisis operations， UDI-6 and IIQ-7 scores were improved significantly （P>0.05）. Post-operative urinary retention was not observed and prolapse recurred in one patient. Conclusion： Colpocleisis is a safe and effective surgical technique in treating the pelvic organ prolapse for the elderly female patients， with a high patient satisfaction rate.

【Key words】Colpocleisis； Pelvic organ prolapse； Efficacy； Satisfaction rate

【中图分类号】R713.4【文献标志码】A

盆腔脏器脱垂（pelvic organ prolapse， POP）常因盆底支持组织缺损或松弛而引起，使得盆腔脏器脱离原先正常的解剖位置，包括子宫脱垂、阴道脱垂，同时伴有膀胱、直肠和小肠膨出。该病的临床症状一般表现为慢性盆腔痛、走路或站立时有下坠感或压迫感以及性交不适，影响患者正常生活[1，2]。如今，随着人口老龄化现象的加剧，POP发病率呈上升趋势。妇女健康研究显示已婚妇女子宫脱垂发病率为0.04%～0.14%，51～60岁妇女发病率为0.33%，60岁以上为0.71%。而对……