骶骨阴道/会阴固定术治疗中盆腔脱垂的初步探讨  

Primary study on the sacrocolpopexy/sacrocolpoperineopexy in the treatment of the middle compartment pelvic organ prolapse

作　　者：王文英[1] 鲁永鲜[1] 张迎辉[1] 沈文洁[1] 刘昕[1] 刘静霞[1] 葛静[1] 牛珂[1] 

机构地区：[1]北京中国人民解放军总医院第一附属医院妇产科,100048

出　　处：《中国妇产科临床杂志》2011年第2期92-95,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：首都医学发展科研基金(20072032)资助

摘　　要：目的探讨骶骨阴道/会阴固定术(SC/SCP)治疗中盆腔脱垂的中短期效果。方法于2005年10月至2010年8月解放军总医院第一附属医院妇产科对8例POP-QⅢ期以上中盆腔脱垂患者进行了经腹及腹腔镜的SC/SCP术,其中骶骨阴道固定术2例,骶骨阴道会阴固定术5例,骶骨宫颈固定术1例。合并压力性尿失禁(SUI)3例,分别进行了尿道中段悬吊术(TVT)及Burch术。采用盆底功能障碍性疾病症状问卷PFDI-20及盆底疾病生活质量影响问卷短表PFIQ-7随访。结果平均手术时间(177.66±31.38)min,平均出血量(355.28±211.18)ml。平均随访24.5个月(2～60个月),8例患者的治愈率为100%。术后2个月发生阴道穹隆补片暴露2例,术后1年发生轻度SUI1例,术后2年发生右侧股疝1例,无盆腔器官脱垂复发。术后1年PFDI-20和PFIQ-7评分分别由术前的(95.29±17.42)分和(101.03±11.49)分减少为(16.60±4.50)分和(12.59±5.65)分(P<0.01)。结论骶骨阴道/会阴固定术可为盆腔器官提供较为持久的支持,治疗中盆腔器官脱垂有较好的疗效。Objective The aim of this study was to evaluate the short and medium treatment outcome of sacrocolpopexy/sacrocolpoperineopexy（SC/SCP）for the middle compartment pelvic organ prolapse（POP）.Methods 8 patients with grade 3 prolapse of the middle compartment were treated between October 2005 to Augest 2010 in First Affiliated Hospital.7 underwent abdominal sacrocolpopexy（ASC）and one underwent laparoscopic sacrocolpopexy（LSCP）.Two patients underwent SC,5 underwent SCP,another one underwent cervical sacrocolpopexy.The median followup was 24.5 months（2~60 months）.3 patients complicated with urinary stress incontinence（SUI）and underwent tensionfree vaginal tape（TVT）and Burch colposuspension at the same time.ResultsThe mean operative time for SC/SCP was（177.66±31.38）min,mean blood lose was（355.28±211.18）ml.The overall anatomic success rates（no recurrence of any prolapse ≥stage 2）was 100%.After 2 years follow up,none prolapse recurrence occurred,1 patient experienced crural hernia.Two patients had small mesh erosion in the cuff 2 months after operation（2/8）.One patient developed de novo mild SUI one year after operation（1/8）.Patients＇ subjective outcome was also evaluated by Pelvic Floor Distress Inventory（PFDI20）and Pelvic Impact Questionnaire（PFIQ7）1 year after operation.The PFDI20 and PFIQ7 scores improved from 95.29±17.42 and 101.03±11.49 to 16.6±4.50 and 12.59±5.65（P0.01）.ConclusionsSC/SCP can provided durable support for the pelvic organ,and it is an effective treatment for middle compartment POP.

关 键 词：骶骨阴道固定 子宫脱垂 手术治疗 中盆腔缺陷 

分 类 号：R713[医药卫生—妇产科学]