经阴道后路悬吊带术治疗阴道穹窿膨出的中远期随访结局  

Medium-and-long term results of posterior intra-vaginal slingplasty for the treatment of vaginal vault prolapse

作　　者：范融[1] 朱兰[1] 郎景和[1] 海宁[1] 王文艳[1] 李琳[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院妇产科,北京100730

出　　处：《现代妇产科进展》2010年第7期527-530,共4页Progress in Obstetrics and Gynecology

摘　　要：目的:探讨经阴道后路悬吊带术(PIVS)治疗女性阴道穹隆膨出的中远期结局。方法:采用回顾性研究方法,对20名子宫切除术后阴道穹隆膨出的患者行PIVS治疗。对其术前、术后资料进行评估,并对术后3年以上随访结果进行总结。结果:平均手术时间53.95±16.88min,术中平均出血量57.50±24.682ml,平均住院天数3.82天,未发生直肠损伤、盆腔血肿等术中严重并发症。半年内所有患者均治愈,中远期随访2例(10.5%)患者因阴道穹隆脱垂复发行子宫托治疗;5例(26.3%)出现吊带侵蚀,剪除后加用雌激素局部治疗,4例好转,1例反复修剪侵蚀的吊带3次,仍有肉芽形成。结论:PIVS术是一种安全、有效、微创的治疗阴道穹隆膨出的手术方式,但术后中远期随访发现吊带侵蚀是一个不可忽视的问题,该术式所用多股编织吊带不宜作为重建材料。Objective：To investigate the medium-and-long term results of posterior intra-vaginal slingplasty（PIVS） in the reconstruction surgery for vaginal vault prolapse.Methods：20 patients with vaginal vault prolapse underwent PIVS,their clinical data was retrospectively studied. Operative details and postoperative follow-up data of more than three years were evaluated.Results：Mean operating time was 53.95±16.88min,average blood loss was 57.50±24.682ml,and average hospitalization period was 3.82d. There was no severe complications such as rectum perforation or pelvic hematoma during the operations. All the patients were cured in the six-months＇ follow up. After a medium-and-long term following up,2 patients（10.5%） who suffered from recurrence of vaginal vault prolapse took pessaries as alternatives. 5 patients（26.3%） were observed tape erosion,and were treated with topical tape resection and estrogen ointment,only one of whom still has granulation after tape resecting for three times.Conclusions：PIVS operation is a safe,effective,minimally invasive operation for vaginal vault prolapse. However,tape erosion was an severe problem that should not be neglected. The polypropylene multifilament mesh is not an optimal material for reconstruction surgery.

关 键 词：阴道后路悬吊带术 阴道穹隆膨出 吊带侵蚀 中远期结局 

分 类 号：R713.3[医药卫生—妇产科学]