改良阴道前后壁联合修补术治疗盆腔器官脱垂的疗效观察  

Improved anterior and posterior vaginal wall repair in treatment of pelvic organ prolapse

作　　者：李棪 王楠[1] 付晓宇[1] 宋磊[1] LI Yan;WANG Nan;FU Xiaoyu;SONG Lei(Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing 100853, China)

机构地区：[1]解放军总医院妇产科,北京100853

出　　处：《解放军医学院学报》2018年第6期491-493,497,共4页Academic Journal of Chinese PLA Medical School

摘　　要：目的分析改良阴道前后壁联合修补术治疗盆腔器官脱垂(pelvic organ prolapse,POP)的临床疗效,探讨改良手术要点。方法选择本院妇产科2015年1月-2016年12月诊治的111例盆腔器官脱垂者作为研究对象,根据手术方式分为两组,观察组(52例)采用改良的阴道前后壁联合修补术,对照组(59例)采用阴式子宫切除+传统阴道前后壁修补术,比较两组治疗和随访情况。结果观察组手术时间[(63.5±19.0)min vs(84.1±27.2)min]、术中出血量[(64.8±20.3)ml vs(103.1±45.7)ml]和治疗费用[(6 102.8±849.3)元vs(9 583.1±1 218.8)元]均少于对照组(P均<0.05),观察组术后阴道长度大于对照组[(6.5±1.4)cm vs(5.1±1.2)cm,P<0.001],总复发率低于对照组(5.8%vs 13.6%,P=0.173)。结论改良阴道前后壁联合修补术治疗POP的手术时间短、出血少、术后阴道长度满意、花费少且易于掌握,适合推广使用。Objective To analyze the clinical effect of combination of anterior and posterior vaginal wall repair on pelvic organ prolapse （POP） and discuss the key points of operation procedure improvement. Methods One hundred and eleven patients with pelvic organ prolapse admitted to the department of obstetrics and gynecology in our hospital from January 2015 to December 2016 were selected. Patients in observation group （n=52） were treated with improved anterior and posterior vaginal wall repair, and control group （n=59） with vaginal hysterectomy plus traditional vaginal wall repair. Results The operating time [（63.5 ± 19.0） min vs （84.1 ± 27.2） mini, amount of bleeding [（64.8 ± 20.3） ml vs （103.1 ± 45.7） ml] and cost of treatment [（6 102.8 ± 849.3） yuan vs （9 583.1 ± 1 218.8） yuan] in observation group were less than those of the control group （all P 〈 0.05）. The length of vagina in observation group was greater than that of the control group [（6.5 ± 1.4） cm vs （5.1 ± 1.2） cm, P 〈 0.05]. The total recurrence rate of the observation group was significantly lower than that of the control group （5.8% vs 13.6%, P=-0.173）. Conclusion Improved anterior and posterior vaginal wall repair has shorter operating time, less bleeding and greater vaginal length. Meanwhile, it has less cost and is easy to master.

关 键 词：盆腔器官脱垂 阴道前后壁修补 盆底重建 阴式手术 保留子宫 

分 类 号：R713.33[医药卫生—妇产科学]