腹腔镜阴道骶骨固定术治疗复发性盆腔器官脱垂的疗效评价  

Efficacy of laparoscopic sacral colpopexy for the repair of recurrent pelvic organ prolapse

作　　者：徐丽珍[1] 张晓薇[1] 黎燕霞[1] 黄晓军[1] 陈永秀[1] 

机构地区：[1]广州医学院第一附属医院妇产科,510120

出　　处：《妇产与遗传（电子版）》2012年第2期21-25,共5页Obstetrics-Gynecology and Genetics (Electronic Edition)

摘　　要：目的评价腹腔镜阴道骶骨固定术治疗复发性盆腔器官脱垂的临床疗效。方法回顾分析9例复发性重度盆腔器官脱垂(穹隆脱垂合并阴道前后壁脱垂)行腹腔镜阴道骶骨固定术的临床资料,采用盆腔器官脱垂定量分期法(POP-Q)评价解剖学疗效,生活质量问卷评价功能学疗效,性生活问卷评价性生活情况。结果手术完成率100%,无术中并发症,无输血病例。平均手术时间50～150min,平均117.5min,术中失血35～200ml,平均80ml。术后1例暂时性尿潴留,停留尿管6d,余术后2d拔尿管后均能自主排尿。随访时间13～51个月,平均(24.1±11.57)月。2例(2/9)网片暴露。新发性交痛、压力性尿失禁各1例。问卷评分显示生活质量由术前121.7±46.2降至术后23.4±16.3,性生活质量由术前27.4±11.3升至34.0±0.7,评分有显著差异(P<0.001)。客观治愈率为100%,主观治愈率100%。结论腹腔镜阴道骶骨固定术用于治疗复发性重度盆腔器官脱垂患者的解剖学及功能学疗效好,是安全、可靠的治疗方法之一。Objective To evaluate the clinical efficacy of laparoscopic sacral colpopexy for the repair of recurrent pelvic organ prolapse.Methods The clinical data of 9 cases of laparoscopic sacral colpopexy for the treatment of recurrent severe pelvic organ prolapse(vault prolapse complicated by the vagina anterior and posterior wall prolapse) were retrospectively analyzed.The anatomic effect,functional effect and the sexual life were separately assessed according to the pelvic organ prolapse quantification(POP-Q),the quality of life questionnaire and the sex life questionnaire.All subjects were aged 45 to 65(56.3±5.4) years and body mass index from 18.5 to 28(22.6±3.5) kg/m2.Results All operations were successfully completed without any impainment.No blood transfusion cases.The mean operative time was 117.5(50~150)min,the mean bleeding lose was 80(35~200)ml.Except for one case of post-operative urinary retention for a period of 6days,9 patients were able to micture spontaneously 2 days post-opreatively.The follow-up time was 13 to 51(24.1±11.57) months.During follow-up,2 cases(2/9) of mesh erosion.one case of Neopathy of sexual pain and one case of stress urinary incontinence occured.Preoperative and Postoperative questionnaire scores showed that the quality of life by(121.7±46.2) to(23.4±16.3),and sexual quality of life from(27.4±11.3) to(4.0±0.68) in the rise.They were significantly improved(P <0.01).The objective and the subjective cure rate were 100%.Conclusion Laparoscopic sacral colpopexy is a safe,reliable and useful treatment for the recurrent pelvic organ prolapse.

关 键 词：脱垂 复发 腹腔镜阴道骶骨固定术 

分 类 号：R713[医药卫生—妇产科学]