改良简易式前盆底重建术治疗阴道穹窿脱垂  

Modified simple anterior pelvic floor reconstruction for vaginal vault prolapse

作　　者：贾秋成 汤慧敏 陈继明 唐斌 魏炜炜 邢庭玮 杜雨 郑虹 施如霞 JIA Qiucheng;TANG Huimin;CHEN Jiming;TANG Bin;WEI Weiwei;XING Tingwei;DU Yu;ZHENG Hong;SHI Ruxia(Department of Gynecology,the Affiliated Changzhou NO.2 People's Hospital of Nanjing Medical University,Changzhou,Jiangsu 213000,China)

机构地区：[1]南京医科大学附属常州第二人民医院妇科,江苏常州213000

出　　处：《手术电子杂志》2023年第2期10-12,共3页Electronic Journal of Medical Operations

基　　金：常州市高层次卫生人才培养工程(2022CZBJ074);江苏省妇幼健康重点人才项目(RC202101);江苏省妇幼健康科研项目(F202138);江苏省博士后科研资助计划(2019K064);江苏省“333工程”科研资助项目(BRA2019161)

摘　　要：手术采用气管插管全麻下取膀胱截石位,消毒铺单后置入导尿管。切开阴道前壁黏膜并向两侧分离至坐骨支,扩大间隙,清晰触诊双侧坐骨棘及骶棘韧带,使用穿刺器沿尿道口两侧切口穿入,经闭孔、坐骨棘上方自阴道旁间隙穿出。放置网片于膀胱下,将网片上下端采用不可吸收丝线缝合两侧子宫主韧带附着处及膀胱颈周围筋膜。距阴道黏膜切缘1 cm处予以可吸收线缝合阴道黏膜,修补阴道前后壁。向外牵拉网片丝线,平皮肤剪除丝线,完成改良简易式前盆底重建。The procedure is performed under general anaesthesia with tracheal intubation in a bladder truncated position,and a catheter is placed after disinfection and sheeting.The mucosa of the anterior wall is incised and separated on both sides to the sciatic branch,the gap is widened and the bilateral sciatic spine and sacrospinous ligaments are clearly palpated.A puncture device is used to penetrate along both sides of the urethral incision,through the closed hole and out of the paravaginal space along the top of the sciatic spine.The mesh is placed under the bladder and the upper and lower ends of the mesh are sutured with non-absorbable silk to the attachment of the main uterine ligaments on both sides and to the fascia around the bladder neck.The vaginal mucosa is sutured with absorbable sutures 1 cm from the incisional edge of the vaginal mucosa and the anterior and posterior vaginal walls are repaired.The mesh sutures are pulled outwards and the sutures are cut off flat to skin to complete the modified simple anterior pelvic floor reconstruction.

关 键 词：改良简易式前盆底重建术 阴道穹窿脱垂 阴道壁修补 

分 类 号：R713.3[医药卫生—妇产科学]