测量骨盆器官脱落:一个进化的进化
1W. Allen Addison Professor and Chair, Department of Obstetrics and Gynecology, Duke University School of Medicine, 203 Baker House, Box 3084, Durham, NC, 27720, USA. matthew.barber@duke.edu.
患者的症状,特别是阴道膨胀,对于骨盆器官脱落 (POP) 的结果比解剖学更重要. 专注于症状治愈,以提高POP研究和治疗的临床相关性.
科学领域:
- 泌尿和妇科 泌尿和妇科
- 盆地底疾病 盆地底疾病
- 女性的盆腔医学
背景情况:
- 了解骨盆器官脱落 (POP) 的进展依赖于有效的解剖学测量和患者报告的结果.
- 盆腔器官脱落量化 (POPQ) 对于评估POP至关重要.
- 了解POP需要评估解剖学和症状方面.
研究的目的:
- 审查 POP 测量技术的演变.
- 讨论POP测量对临床实践和研究的影响.
- 突出患者报告结果在POP管理中的重要性.
主要方法:
- 对POP测量演变的文献综述.
- 分析使用盆腔器官脱落量化 (POPQ) 的研究.
- 对POP严重程度和治疗成功的解剖学和主观测量进行比较.
主要成果:
- 某种程度的解剖性脱落是常见的,即使在无症状的妇女.
- 阴道膨胀症状是POP的最具体的指标.
- 盆地症状和解剖学严重程度之间的相关性是微弱到中度的.
- 由于不同的标准,治疗成功率差异很大;解剖学成功定义往往过于严格.
- 治疗成功的主观和解剖学指标之间存在显著的不一致.
结论:
- 骨盆器官脱落是一种复杂的,多维的疾病,对患者产生重大影响.
- 患者的症状,特别是无阴道膨胀,在临床上比解剖治疗更重要.
- 复合结果可能具有误导性;对于未来的研究来说,更喜欢连续变量.
- 未来的研究应该优先考虑症状结果和连续变量,而不是二元化的成功/失败指标.
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