举宫杯辅助下腹腔镜骶骨阴道固定术与协和式全盆底重建术治疗盆腔器官脱垂的对比研究  

Comparison between Curette Assist Laparoscopic Sacrocolpopexy and Modified Pelvic Floor Reconstruction for the Treatment of Pelvic Organ Prolapse

作　　者：李顺双 纪妹[1] 

机构地区：[1]郑州大学第一附属医院,河南郑州450052

出　　处：《实用妇产科杂志》2015年第5期388-391,共4页Journal of Practical Obstetrics and Gynecology

基　　金：河南省科技攻关计划项目(编号:112102310105)

摘　　要：目的:比较举宫杯辅助下腹腔镜骶骨阴道固定术(CALS)与协和式全盆底重建术在治疗盆腔器官脱垂的临床疗效。方法:回顾性分析2011年1月至2013年5月于郑州大学第一附属医院行CALS 26例(CALS组)与同期行协和式全盆底重建术的43例患者(小网片组)的临床资料,包括一般情况、围手术期情况、POP-Q指示点数值、复发率、网片侵蚀率。结果:除术中出血量CALS组(29.8±22.2 ml)较小网片组(156.5±61.8 ml)明显减少外(P<0.01),手术时间、术后保留尿管时间、住院天数两组差异无统计学意义(P>0.05)。两组自身POP-Q各指示点除阴道全长(TVL)外,其余各指示点数值术前、术后差异均有统计学意义(P<0.01);两组术前POP-Q各指示点数值差异无统计学意义(P>0.05);两组术后各指示点数值相比,仅C点、TVL差异有统计学意义(P<0.05)。CALS组和小网片组比较术后1年的复发率、侵蚀率,差异均有统计学意义(P<0.05)。结论:CALS和协和式全盆底重建术均能恢复盆腔解剖结构,而CALS术后复发率及网片侵蚀率低,是一种更安全、有效的治疗盆腔器官脱垂的手术方式。Objective： To compare the clinical effects of curette assist laparoscopic sacrocolpopexy（ CALS） and modified pelvic floor reconstruction for pelvic organ prolapse（ POP）. Methods： Twenty-six women who underwent CALS and forty-three women who underwent modified pelvic floor reconstruction for POP at the First Affiliated Hospital of Zhengzhou University from January 2011 to May 2013 were included in this retrospective study. Clinical data included baseline characteristics,peri-operation status,POP quantification（ POP-Q） value,recurrence rate,and erosion rate. Results： Apart from blood loss（ 29. 8 ± 22. 2 ml vs 156. 5 ± 61. 8 ml）,there was no significant difference in the operative duration,postoperative catheterization time or hospital stay between CALS group and mini mesh group. There were significant differences in POP-Q parameters,except point total vagina length（ TVL）,between two groups（ P〈0. 01）. There was significant difference in none of the points before surgery（ P〈0. 05）,and there was significant difference in points C and TVL after surgery（ P〈0. 05）. The 1-year recurrence rate was 0 and 9. 3% in CALS and mini mesh group,respectively（ P〈0. 05）. The 1-year erosion rate was0 and 11. 6% in CALS and mini mesh group,respectively（ P〈0. 05）. Conclusions： Curette Assist Laparoscopic Sacrocolpopexy and modified pelvic floor reconstruction were both effective to the anatomic correction of POP.But with the lower rate of recurrence and erosion,but in term of recurrence and erosion among women with POP.Curette Assist Laparoscopic Sacrocolpopexy was more safe and effective.

关 键 词：盆腔器官脱垂 举宫杯 腹腔镜 骶骨阴道固定 协和式全盆底重建 

分 类 号：R713[医药卫生—妇产科学]