盆底器官脱垂患者经全盆底重建术治疗后炎症反应、应激反应及尿流动力学变化

摘要

Objective:To investigate the changes of inflammatory response,stress response and urodynamic changes af-ter total pelvic floor reconstruction in patients with pelvic organ prolapse. Methods:According to random data table method, 80 cases of pelvic organ prolapse were randomly divided into the control group(n=40)and observation group(n=40),pa-tients in the control group were given conventional vaginal hysterectomy plus vaginal wall repair sugery and the observation group received total pelvic floor reconstruction. The levels of the serum inflammatory factor,oxidative stress before and after surgery,and postoperative urodynamic changes were compared. Results:The levels of serum hs-CRP,IL-1β,TNF-α,NE,E and Ins in the two groups before treatment were not statistically significant(P>0.05). Compared with the group before treat-ment,the levels of hs-CRP,IL-1β,TNF-α,NE,E were significantly increased in both groups after treatment(P<0.05), and the observation group levels were significantly lower than those in the control group after treatment(P<0.05);in terms of urodynamics,the postoperative maximal bladder volume and Qmax were significantly higher in the observation group than in the control group(P<0.05),the postoperative levels of PdetQMax,PdetMax and PVR in the observation group were signifi-cantly lower than those in the control group(P<0.05). Conclusion:Compared with vaginal hysterectomy plus vaginal wall re-pair sugery,total pelvic floor reconstruction can light the patient's inflammation,stress response and improve the patient's uri-nary function,and the overall effect is better which has important clinical value.%目的:探讨盆底器官脱垂患者经全盆底重建术治疗后炎症反应、应激反应及尿流动力学变化.方法:选择80例盆底器官脱垂患者依据随机数据表法分为对照组(n=40)和观察组(n=40),对照组患者行阴式子宫切除加阴道壁修补术,观察组患者接受全盆底重建术治疗.比较手术前后两组血清炎症因子、应激指标及术后尿流动力学水平变化.结果:术前,两组的血清hs-CRP、IL-1β、TNF-α、NE、E及Ins水平较为接近,无统计学差异(P>0.05).术后,两组患者血清hs-CRP、IL-1β、TNF-α、NE、E及Ins水平与同组术前相比均明显升高,且观察组明显低于对照组,差异对比有显著性(P<0.05).在尿流动力学方面,术后观察组最大膀胱测定容积、Q max 显著高于对照组术后水平,差异有统计学意义(P<0.05);观察组PdetQMax、PdetMax及PVR水平显著低于对照组术后水平,差异有统计学意义(P<0.05).结论:与阴式子宫切除加阴道壁修补术相比,全盆底重建术能更好减轻患者炎症、应激反应并且有助于患者排尿功能的改善,整体效果较好,具有重要的临床价值.