| ObjectiveThrough for patients with pelvic organ prolapse need operation,preoperative vaginal give estriol ointment treatment to explore its effective degree whether is associated with pelvic fascia defect parts,preliminary judgment pop patients with pelvic fascia defect parts,to provide a reference for the selection of late treatment and surgical approach.MethodsThis study to choose from December January 2010 to 2015 for treatment of pelvic organ prolapse in Taishan Medical College Affiliated Hospital of gynecology and surgical treatment of 35 cases of patients,35 patients were aged at the age of 46-77,with an average of 62.17±9.31 years of old,menopausal time for half a year to 29 years,an average of 12.72±10.01 years,pregnant times 2-8 times,on average of 3.86±1.46 times,production from 1 to 5 times,2.69±1.21 times on average.The clinical application of Petros evaluation system of each patient were examined and recorded the whole theory of pelvic injury,according to the site of injury were divided into three groups,including 11 cases of patients with anterior pelvic injury.In 16 cases of patients with pelvic injury,8 cases of patients with damage to the rear.Three groups of patients before surgery were treated with vaginal estriol ointment local application for 2 weeks,once a day,0.5 g each time,twice a week and also 0.5g each time in next 2 weeks,Before and after treatment respectively for patients of pelvic floor dysfunction questionnaire(pelvic floor may Inventory-Short Form 20,PFDI-20)to investigate the in order to understand the improvement of the subjective symptoms of the patients before and after treatment,vaginal examination and POP-Q score objectively determine the patient's condition changes,symptom checklist points to reduce 50% as effective indicators,POP-Q system to reduce a level as a treatment for effective index,consistent with subjective symptoms or objective evaluation of an effective index is considered for the effective treatment,respectively,the curative effect of three groups of patients improvement are evaluated,to determine the effects of estrogen therapy with pelvic floor fascia defect parts without correlation.Results:1.General clinical data comparison between the effective group and invalid group:Between the two groups of age,pregnant time,production time and the compare the menopause,P>0.05,there were no statistically significant difference.?2.Subjective symptoms curative effect observation:3 groups of study applcation of PFDI-20 for rating survey and statistical analysis of the results before and after medication,the damage to the front and the middle of the pelvic cavity damage patients: P<0.05,the difference is statistically significant,estrogen therapy is effective of pop in patients with pelvic fascia defect located in the front and middle pelvic;the damage to the posterior pelvic injury patients,P>0.05,the difference is not statistically significant,estrogen therapy is ineffective of pop in patients with pelvic fascia defect located in the posterior pelvic.3.Objective indicatiors before and after medication:The damage to the front and the middle of the pelvic cavity damage patients: the change of Aa and Ba points are obviously improved,P < 0.05,the difference is statistically significant.All other points drug used before and after the change is not big,P>0.05,are not statistically significant;the damage to the posterior pelvic injury patients,P>0.05,the difference is not statistically significant,estrogen therapy is ineffective of pop in patients with pelvic fascia defect located in the posterior pelvic.4.3 groups of different pelvic damaged area after the application of estrogen therapy effect comparison:1)damage to the front of the pelvic cavity and the middle of the pelvic cavity damage patients:11 cases of pelvic damage to the front of the object of study,estrogen ointment vagina after local treatment effective number for 8 cases,16 cases of damaged pelvic central research object,15 cases of local vaginal estrogen ointment in the treatment of effective,only 1 case is invalid.Statistical analysis of the two groups: P>0.05,the difference was not statistically significant,that is,the patients with anterior pelvic injury and the central part of the application of estrogen ointment in the middle of the middle of the pelvic cavity were not significantly different after 2 weeks of treatment.2)Patients with anterior pelvic injury and posterior pelvic injury were compared:11 cases of pelvic damage to the front of the object of study,estrogen ointment vagina after local treatment effective number for 8 cases,8 cases of pelvic damage to the rear of the object of study,giving of local vaginal estrogen ointment in the treatment were ineffective.Two groups were statistically analyzed: P < 0.05,the difference was statistically significant,namely anterior pelvic damaged patients with pelvic posterior impaired patients with vaginal topical application of estrogen ointment in the treatment of 2 weeks after treatment,the effect is different,the front of the pelvic impaired patients after effective,and posterior pelvic impaired patients were ineffective.3)the middle of the pelvic cavity damage patients and posterior pelvic injury patients:16 cases of damaged pelvic central research object,15 cases of local vaginal estrogen ointment in the treatment of effective,only 1 cases ineffective,8 cases of pelvic damage to the rear of the research object,giving of local vaginal estrogen ointment in the treatment were ineffective.Two groups were statistically analyzed: P < 0.01,the difference was statistically significant,namely in the middle of the pelvic damaged patients with pelvic posterior impaired patients with vaginal topical application of estrogen ointment in the treatment of 2 weeks after treatment,the effect is different,in the middle of the pelvic impaired patients after effective,and posterior pelvic impaired patients after the invalid.ConclusionThe pop patients preoperative vaginal topical application of estrogen ointment,according to symptoms to improve the situation,can preliminary judgment of pelvic fascia defect sites: symptoms improved obvious pop patients with pelvic fascia defect sites for pelvic anterior and middle of the damaged parts,the estrogen therapy can be a short-time treatment;invalid application of estrogen in the treatment of pop in patients with pelvic fascia defect in the posterior pelvis,Petros evaluation system of 5,6 parts,namely uterosacral,main ligament rupture patients,the surgical treatment is the only effective treatment. |
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