改良全盆底重建治疗盆底障碍性疾病临床研究  

Clinical research on modified total pelvic floor sling in treatment of female pelvic floor dysfunction

作　　者：李晓芳[1] 罗长华[1] 邢辉[1] 

机构地区：[1]襄樊学院附属襄阳中心医院妇产科,湖北襄阳441021

出　　处：《医药论坛杂志》2011年第16期1-3,共3页Journal of Medical Forum

基　　金：湖北省卫生厅青年人才基金(编号QJX2008-61)

摘　　要：目的探讨改良全盆底重建术(童氏)治疗女性盆底功能障碍性疾病的效果。方法对32例根据POP-Q分度法达Ш度及Ш度以上盆底功能障碍性疾病的女性患者行改良全盆底重建术,应用自制聚丙烯网片对子宫主韧带、骶韧带、阴道前后壁、膀胱宫颈韧带进行全盆底悬吊,合并压力性尿失禁的患者同时进行改良经闭孔尿道中段无张力悬吊术(改良TVT-O术)。结果 32例患者手术全部完成,平均手术时间(98.15±15.14)min,术中平均出血(120.17±40.15)ml,平均住院时间(5.15±2.18)d,术后随访平均为10个月。根据POP-Q分度法及问卷评价手术效果,32例患者手术后盆腔器官脱垂症状全部得以纠正,盆底结构基本正常,所有病例全部治愈。结论上述改良全盆底重建术是一种能治疗多区域、复杂型盆腔器官脱垂的微创手术。在保留子宫的同时能完成全盆底结构和功能的全部或部分重建,手术方法安全、微创。Objective To explore the effectiveness of medified pelvic floor sling in treament of female pelvic floor dysfunction（PED）.Methods Totally 32 female patients with PED of grade Ⅲ or above Ⅲ according to POPQ underwent modified pelvic floor seling,self-made polypropylene mesh was used to hang cardinal ligament of uterus,utero-sacral ligament,vaginal anterior wall and back wall and cervical ligament of bladder,for the patients combined with stress urinary incontience,modifed tension-free vaginal tape-obturator（TVT-O）was conducted.Results The operation was finished completely,the average operative time was（98.15±15.14）min,the average blood loss was（120.17±40.15）ml during operation,the hospitalization time was（5.15±2.18） d,the patients were followed up for 10 month the pelvic floor structure returned to normal,all the patients were cured.Conclusions Modified total pelvic floor sling is a mini-invasivc surgery,which can cure multi-region and complex pelvic organ prolapse,and reconstruct pelvic floor stucture and reconstruction completely or partially with the advantages of safety and mini-invasion.

关 键 词：盆腔器官脱垂 子宫脱垂 全盆底悬吊术 盆底重建 盆底功能障碍性疾病 

分 类 号：R711.2[医药卫生—妇产科学]