女性盆底功能障碍性疾病的诊疗进展_王建六

33%,25%,13%,88%,20%。,UAE[5]。UAE,。,UAE。UAE。。UAE,,UAE。:(1),。(2),。(3),UAE。Ahmad[14]3226～45(34)UAE,UAE3(FSH)(6.83±1.80)IU/L(6.99±1.67)IU/L,,2～3。2FSH22IU/L30IU/L40IU/L48IU/L,。UAE,UAE,。UAE、。、、UAE。40,、、[15]。,,,“”,,,,UAE。[1]　RavinaJH,HerbreteauD,Ciraru-Vigneron,etal.Arterialem-bolisationtotreatuterinemyomata[J].Lancet,1995,346:671-672.[2]　,,,.42[J].,2002,37(1):8-11.[3]　HurstBS,StackhouseDJ,MatthewsML,etal.Uterinearteryembolizationforsymptomaticuterinemyomas[J].FertilSteril,2000,74:855-869.[4]　RavinaJH.Embolizationofuterinemyomata:methods,limitsandfuture[C].Chile:XIIFIGOWorldCongressofGynecologistandObstetrics,2003.[5]　RavinaJH,LedreffO.Arterialembolizationofuterinemyoma:resultsaproposof286cases[J].JGynecolObstetBiolReprod,2000,29(3):272-275.[6]　MessinaML,BozziniN,HalbeHW,etal.Uterinearteryembo-lizationforthetreatmentofuterineleiomyoma[J].IntJGynae-colObstet,2002,79(1):11-16.[7]　BroderMS,GoodwinS,ChenG,etal.Comparisonoflong-termoutcomesofmyomectomyanduterinearteryembolization[J].ObstetGynecol,2002,100(5Pt1):864-868.[8]　McLucasB,AdlerL,PerrellaR.Uterinefibroidembolization:nonsurgicaltreatmentforsymptomaticfibroids[J].JAmCollSurg,2001,192:95-105.[9]　EdwardsRD,MossJG,LumsdenMA,etal.Committeeoftherandomizedtrialofembolizationversussurgicalforsymptomaticuterinefibroids[J].NEnglJMed,2007,356:360-370.[10]　DavidM,EbertAD.Treatmentofuterinefibroidsbyemboliza-tion-advantages,disadvantages,andpitfalls[J].EurJObstetGynecolReprodBiol,2005;123:131-138.[11]　ParkerWH.Uterinemyomas:management[J].FertilSteril,2007,inpress.[12]　GoldbergJ,PereiraL,BerghellaV.Pregnancyafteruterinear-teryembolization[J].ObstetGynecol,2002,100:869-872.[13]　CarpenterTT,WalkerWJ.Pregnancyfollowinguterinearteryembolizationforsymptomaticfibroids:aseriesof26completedpregnancies[J].BJOG,2005,112:321-325.[14]　AhmadA,QadanL,HassanN,etal.Uterinearteryemboliza-tiontreatmentofuterinefibroids:effectonovarianfunctioninyoungerwomen[J].JVascIntervRadiol,2002,13(10):1017-1020.[15]　LockwoodCJ.Ifyourpatienthassymptomaticmyomas,isUAEanoption?[J].ContemporaryOb/Gyn,2007,April.9-11.(2007-10-20):1005-2216(2008)01-0030-04王建六,张晓红:盆底功能障碍性疾病;压力性尿失禁keywords:pelvicfloordysfunctionaldisease;stressurinaryincontinence:R71　　:A:,100044:[e-mail]　　(pelvicfloordysfunctionaldisease,PFD),40%,(pelvicorganprolapse,POP)·30·20081241(stressurinaryincontinence,SUI)。,:。POPSUI,、,(ICS)(IUGS)。PFD,。2005,,,,,。。1　1852Marion,100,,。。2%～46%,2002163,。,(),1/3。20。、18.1%～57.5%,50%。、,。,、,、,5。,,1/3。,,。,,,。4,6.6%7.4%30%;,45.9%27.8%;50.8%。,,,。,,,。,,,,。2　,,。,,,,(ATFP),(PCF),(ZCE)。,。(anteriorcom-partment)、(middlecompartment)(posteri-orcompartment),、、;、;、。。,。,,,,,。2。,,,,,。。,。,。、。。,。,。。、[1]。,DeLancey[2]3,。3。(level1):(suspension),(sacrospinousliga-ment)(pericervicalring),-、1/3,;(level2):(lateralattachment),(rectovaginalfascia)、(pubocervicalfascia)(arcustendineusfasciapelvis,ATFP),(levatorani)、2/3;(level3):(distalfusion),,,。,,。·31·200812413　,POP,,(mesh)、(posteriorintra-vaginalsling,P-IVS)、(sacrospinousligamentfixation,SSLF)、()(sacrakcolpopexy),,,,。3.1　　。,(mesh)。,23.4(18～39)。,1。。Behnia-Willison[3],212,14,18,84%,,。,。Daneshgari[4]15、,12,1,1,1。81mL,2.4d,,,。,Falagas[5],0～8%,0～33%,、、、、、。,(22.4%)[6]。,:;,;;;;。,,,。,、,。,。3.2　(totalpelvicreconstruction)　,。。3,,,。Prolift,110Prolift,12;3,5(4.7%),4.7%(Ⅰ);,[7]。Prolift,,,,,。Petros,,,,,。,。Komesu[8]30,。,,,。3.3　　1996Ulmsten(tension-freevaginaltape,TVT),TVT,。2001Delorme[9](TVT-O),。TVT-O,,,。Jeon[10]TVT、TVT-OBurchSUI,TVT-OTVTBurch,。TVTSecureSystem,。,“hammock”,;,“U”,,。93%,1511[11]。,,。,,,。,。,POP,,,。[1]PetrosPE.Thefemalepelvicfloor-function,dysfunctionandman-agementaccordingtotheintegraltheory[J].SpringerMedizinVerlagHeidelberg,2004,95:137-141.[2]DeLanceyJOL.Structuralsupportoftheurethraasitrelatestostressincontinence:thehammockhypothesis[J].AmJObstetGynecol,1994,170:1713-1723.[3]Behnia-WillisonF,SemanEI,CookJR,etal.Laparoscopicpa-·32·20081241ravaginalrepairofanteriorcompartmentprolapse[J].JMinimInvasiveGynecol,2007,14(4):475-480.[4]DaneshgariF,KeferJC,MooreC,etal.Roboticabdominalsa-crocolpopexy/sacrouteropexyrepairofadvancedfemalepelvicor-ganprolaspe(POP):utilizingPOP-quantification-basedstagingandoutcomes[J].BJUInt,2007,100(4):875-879.[5]FalagasME,VelakoulisS,IavazzoC,etal.Mesh-relatedinfec-tionsafterpelvicorganprolapserepairsurgery[J].EurJObstetGynecolReprodBiol,2007,134(2):147-156.[6],,,.-18[J].,2006,7(1):9-12.[7]FattonB,AmblardJ,DebodinanceP,etal.Transvaginalrepairofgenitalprolapse:preliminaryresultsofanewtension-freevaginalmesh(Prolifttechnique)-acaseseriesmulticentricstudy[J].IntJPelvicFloorDysfunct,2007,18:743-752.[8]KomesuYM,RogersRG,Kammerer-DoakDN,etal.Posteriorrepairandsexualfunction[J].AmJObstetGynecol,2007,197(1):101-106.[9]DelormeE.Transobturatorurethralsuspension:mini-invasiveprocedureinthetreatmentofstressurinaryincontinenceinwomen[J].ProgUrol,2001,11:1306-1313.[10]　JeonMJ,ChungDJ,ParkJH,etal.Surgicaltherapeuticindexoftension-freevaginaltapeandtransobturatortapeforstressuri-naryincontinence[J].GynecolObstetInvest,2007,65(1):41-46.[11]　MartanA,MasataJ,SvabikK.TVTsec