盆底重建術(shù)后性功能及身體形象改變的分析

桑慶娜　王魯文　聶讓讓　賈慧　夏小飛　宋易坤　侯亞楠

【摘要】 目的：分析兩種不同盆底重建術(shù)后女性性功能及自我身體形象評價的改變。方法：選取2014年1月-2016年1月本院因中重度盆腔器官脫垂（POP）行手術(shù)治療的患者100例，根據(jù)手術(shù)方式不同將其分為經(jīng)陰道植入網(wǎng)片組68例和自體組織修補組32例，治療前、治療后6個月、治療后1年分別填寫盆腔器官脫垂/尿失禁性功能問卷（PISQ-12）、改良女性自我身體形象評價量表（MBIS），評價盆底重建術(shù)后性生活質(zhì)量及身體形象的改變情況。結(jié)果：治療后6個月，經(jīng)陰道植入網(wǎng)片組PISQ-12評分較自體組織修補組降低（P=0.034）；治療后1年，兩組PISQ-12評分均較治療前改善（P<0.05），且經(jīng)陰道植入網(wǎng)片組PISQ-12評分較自體組織修補組明顯升高（P=0.030）。治療后6個月與治療后1年兩組MBIS評分均較治療前改善（P<0.05）；治療后1年，經(jīng)陰道植入網(wǎng)片組較自體組織修補組升高明顯（P=0.015）。結(jié)論：經(jīng)陰道植入網(wǎng)片及自身組織修補均可改善POP患者性功能及身體形象，隨時間進(jìn)展經(jīng)陰道植入網(wǎng)片組改善更明顯。

【關(guān)鍵詞】 盆底重建術(shù)； 性生活質(zhì)量； 身體形象

Analysis of Sexual Function and Body Image Changes after Pelvic Floor Reconstruction Surgery/SANG Qingna，WANG Luwen，NIE Rangrang，et al.//Medical Innovation of China，2017，14（32）：025-028

【Abstract】 Objective：To analyze the changes of female sexual function and self body image after two different pelvic reconstructive surgery.Method：100 cases of moderate to severe pelvic organ prolapse （POP） underwent surgical treatment in our hospital from January 2014 to January 2016 were selected，according to the different surgical methods，they were divided into 68 cases of transvaginal mesh repair group and 32 cases of autologous tissue repair group.The pelvic organ prolapse/incontinence sexual function questionnaire（PISQ-12） and the modified female self body image assessment scale（MBIS） were completed before treatment，6 months after treatment and 1 year after treatment，to evaluate the changes of sexual quality and body image after pelvic reconstructive surgery.Result：6 months after treatment，PISQ-12 score of transvaginal mesh repair group was lower than that of autologous tissue repair group（P=0.034），1 year after treatment，PISQ-12 scores of two groups were better than those of before treatment（P<0.05），and PISQ-12 score of transvaginal mesh repair group was significantly higher than that of autologous tissue repair group（P=0.030）.6 months after treatment and 1 year after treatment，MBIS scores of two groups were better than those of before treatment（P<0.05），after 1 year of treatment，MBIS scores of transvaginal mesh repair group was significantly higher than that of autologous tissue repair group（P=0.015）.Conclusion：Transvaginal mesh and self tissue repair can improve the sexual function and body image of POP patients，and the improvement of vaginal implant mesh group is more obvious with time.

【Key words】 Pelvic floor reconstruction surgery； Sexual function； Body image

First-authors address：The Third Affiliated Hospital of Zhengzhou University，Zhengzhou 450000，Chinaendprint

doi：10.3969/j.issn.1674-4985.2017.32.006

盆腔器官脫垂（POP）是一類由各種原因?qū)е碌呐璧字С纸M織薄弱，造成盆腔器官下降移位引發(fā)器官位置及功能異常的疾病，是女性常見的非致命性疾病，常伴有排便、排尿和性功能障礙。POP的癥狀不僅影響患者的生活質(zhì)量，同時可能或引起患者抑郁、焦慮等心理[1]，而POP患者的外生殖器形象降低及抑郁心理可能會引起女性性功能或性生活質(zhì)量降低[2]。有研究顯示，POP患者性生活質(zhì)量降低可能與身體形象降低有關(guān)，目前關(guān)于POP治療主要為盆底重建術(shù)，但手術(shù)對性功能的影響仍有爭議[3]。為此，本研究通過比較術(shù)前、術(shù)后1年內(nèi)盆腔器官脫垂/尿失禁性功能問卷（PISQ-12）、改良女性自我身體形象評價量表（MBIS）來評估不同盆底重建術(shù)后性功能及自我身體形象評價的改變[4]。現(xiàn)報道如下。……