改良经阴道骶骨阴道固定术治疗中盆腔脏器脱垂的临床研究  

Clinic Study of Modified Transvaginal Sacrocolpopexy for Middle Compartment Pelvic Organ Prolapse

作　　者：曲路芸[1] 王彦[1] 姜海洋[1] 陈勇华[1] 王文双[1] 刘春艳[1] 宋志云[1] 

机构地区：[1]山东省青岛大学医学院附属烟台毓璜顶医院妇科,山东烟台264000

出　　处：《中华妇幼临床医学杂志（电子版）》2013年第2期151-154,共4页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：山东省烟台市科技发展计划项目(2011229)~~

摘　　要：目的探讨改良经阴道骶骨阴道固定术治疗中盆腔脏器脱垂的临床价值。方法选择2011年11月至2012年1月,子宫切除术后及需行子宫切除术的中盆腔脏器脱垂患者5例为研究对象,并对其手术时间,术中出血量,术中并发症,术后病率,术后排尿情况,排便时间,住院时间及术前、术后C点位置恢复情况进行分析(本研究遵循的程序符合本院人体试验委员会制定的伦理学标准,得到该委员会批注,征得受试对象的知情同意并与之签署临床研究知情同意书)。结果 5例患者手术均成功,平均手术时间为(136.2±34.4)min,平均术中出血量为(55.3±27.8)mL,术中无一例发生相关并发症。术后第1天晨起拔除尿管后均自解小便顺利;1例患者同时行腹腔镜下全子宫切除+双附件切除术,术后第2天发生不全肠梗阻,予对症治疗,术后12d肠功能完全恢复出院。另外4例患者于术后48h内恢复排气,平均术后住院时间为5.4d。术后即刻、术后8周随访时C点测量值均在-6cm以上,客观治愈率为100%,亦无一例患者发生阴道前后、壁膨出。结论改良经阴道骶骨阴道固定术为中盆腔脏器脱垂的手术,具有利用人体自然通道、阴道轴向不发生改变、术中出血量少、术后创伤小及恢复快等优势。Objective To discuss the clinic value of modified transvaginal sacrocolpopexy for the middle compartment pelvic organ prolapse. Methods Five patients with middle compartment pelvic organ prolapse were treated by transvaginal sacrocolpopexy between November 2011 to January 2012 in Yantai Yuhuangding Hospital. And the following items were observed, the duration of operation, bleeding loss, complications, postoperative morbidity, urination after operation, defecation after operation, hospitalization time, and the position of C point. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Yantai Yuhuangding Hospital. Informed consent was obtained from all participates. Results The operations in five patients were smoothly completed. The average operative time was （136. 2 ± 34. 4） rain, average blood loss was （55. 3 ± 27. 8） mL during operation, there was no complications. All the patients could urinate by themselves in one day after operation. One patient had incomplete intestinal obstruction in two days after operation, but she recovered in twelve days. Other four patients had the normal function of intestine in two days after operation. The hospitalization time after operation were 5.4 d. The measurement of C point for all patients in immediate post-operation and 8 weeks after operation were above -6 cm. The objective cure rate was 100%. Conclusions Transvaginal sacrocolpopexy can use the body% natural channel, restore the normal anatomy without changing the vaginal axial. The advantages of transvaginal sacrocolpopexy includes less blood loss, less trauma, quiker discovery.

关 键 词：中盆腔脏器脱垂 经阴道 骶骨阴道固定术 

分 类 号：R713[医药卫生—妇产科学]