经阴道后路悬吊术治疗子宫及阴道壁脱垂不良结局分析  

Analysis of poor outcomes of posterior intravaginal slingplasty for pelvic organ prolapse

作　　者：高阗[1] 李怀芳[1] 夏红[1] 张弋[1] 童晓文[1] 樊伯珍[1] 

机构地区：[1]同济大学同济医院妇产科,上海200065

出　　处：《上海交通大学学报（医学版）》2009年第4期440-442,共3页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(30471815)~~

摘　　要：目的通过对经阴道后路悬吊术（PIVS）治疗子宫及阴道壁脱垂引起的不良结局进行分析，探讨PIVS的利弊以及提出可能解决问题的有效方法。方法对行PIVS后出现不良结局的7例患者的临床资料进行回顾性分析。首次术式以PIVS为主，术后7例患者均出现阴道前壁Ⅲ度膨出；再次或第三次手术时加用前盆腔悬吊术。结果随访24～36个月，平均30．5个月，患者无复发及其他并发症。结论忽视盆底修补手术的受力点，在软组织间寻找修补手术的支撑是导致复发的重要原因；手术的关键受力点应在骨盆骨，而非盆底组织中已经受损的韧带或筋膜。Objective To analyse the poor outcomes of posterior intravaginal slingplasty （PIVS） for the treatment of pelvic organ prolapse, investigate the advantages and disadvantages of the procedure and put forward the possible way out. Methods The clinical data of 7 patients with poor outcomes after PIVS were retrospectively analysed. After first procedure with PIVS, stage Ⅲ anterior vaginal prolapse were found in all the patients. Anterior pelvic suspension was performed in the second or third procedure. Results The patiens were followed up for 24 to 36 months with an average of 30.5 months, and no recurrence or the other complications were observed. Conclusion Seeking support point in the soft tissues, ignoring the working point in pelvic floor reconstruction, is the important factor for recurrence. The successful pelvic reconstruction depends on the pelvic bone, the key working point, instead of the impaired ligament or fascia in pelvic floor.

关 键 词：经阴道后路悬吊术 盆底功能障碍 前盆腔悬吊术 

分 类 号：R713.4[医药卫生—妇产科学]