部分可吸收Y型网片应用于腹腔镜下阴道骶骨固定术的临床疗效  

Clinical effectiveness of the use of Artisyn-Y shape mesh in laparoscopic sacral colpopexy

作　　者：苏圣梅 曾薇薇[1] 陈琛[1] 袁桢[1] 刘剀[1] 都红蕾[1] 王佳慧[1] Su Shengmei;Zeng Weiwei;Chen Chen(Department of Obstetrics and Gynecology,Shenzhen Maternal ＆ Child Healthcare Hospital Affiliated to Southern Medical University,Shenzhen 518000)

机构地区：[1]南方医科大学附属深圳市妇幼保健院盆底微创妇科,深圳518000

出　　处：《现代妇产科进展》2018年第8期566-570,共5页Progress in Obstetrics and Gynecology

摘　　要：目的:分析部分可吸收Y型网片应用于腹腔镜下阴道骶骨固定术(LSC)的临床疗效,评价其对盆腔器官脱垂(POP)治疗的有效性和安全性。方法:回顾分析2014年8月至2016年10月在南方医科大学附属深圳市妇幼保健院因POP使用部分可吸收网片行LSC术的43例患者的临床资料。随访患者术后3、6、9、12个月时的网片暴露、异物感差异,以及手术前、后盆腔器官脱垂定量(POP-Q)分度法各指示点位置,评价总体主观、客观治愈率及复发率。通过盆腔脏器脱垂/尿失禁性功能问卷(PISQ-12)、盆底功能障碍性疾病症状问卷简表(PFDI-20)等相关问卷评价术后生活质量、性生活改善情况。结果:43例患者术后POP-Q各指示点可达解剖复位,总体主观治愈率100%,总复发率2.3%。术后随访3、6、9、12个月时,患者POP-Q各指示点及相关问卷评分比较,差异均无统计学意义(P>0.05),与术前相比,术后阴道长度无明显缩短(P>0.05),CRADI-8评分无明显改变(P>0.05)。1例压力性尿失禁(SUI)患者行LSC同时行经耻骨后无张力尿道中段悬吊带术(TVT-E),术后尿失禁治愈;2例SUI、1例急迫性尿失禁(UUI)、1例混合性尿失禁(MUI)未行TVT-E治疗,1例在LSC术后症状消失,3例症状程度无改变。结论:部分可吸收Y型网片应用于LSC的主、客观治愈率高,不仅达到解剖学复位,还能显著提高患者的术后生活质量,术后疗效稳定,术后阴道长度无明显缩短,异物感发生率低。部分可吸收网片为LSC的材料植入提供了一种新的选择。Objective： To study clinical curative effect and complications of laparoscopic sacral colpopexy,with the use of partially absorbable Artisyn-Y shape mesh. To evaluate the safety and efficacy of this procedure in treatment of pelvic organ prolapse（ POP）. Methods：From Aug.2014 to Oct.2016,43 patients who had undergone laparoscopic sacral colpopexy for POP in the Shenzhen Maternal Child Healthcare Hospital Affiliated to Southern Medical University,with the use of Artisyn-Y shape mesh were studied retrospectively. Primary respectively to evaluate the mesh erosion condition and foreign body reaction in different postoperation period（ 3 month、6 month、9 month、12 month）. The subjective、objective cure rate and recurrence rate were assessed with POP-quantitation（ POP-Q） system that was measured before and after operation.Postoperative quality of life and sexual was measured through the pelvic floor distress inventory short form（ PFDI-20）. Results： 43 patients were followed up for 12 months. The overall objective cure rate was 100%,and the total recurrence rate was 2.3%.Postoperative each indicator point was reset anatomically according to POP-Q.The median postoperative vaginal length was not shortened than preoperative length（ P〉0.05）.The median score of postoperative PFDI-20 was obviously improved compared to the preoperative. 1 SUI case underwent TVT-E procedure simultaneously and the symptom vanish.2 SUI cases、1 UUI case、1 MUI case were not underwent TVT-E,one of them got symptom vanish.Conlusions： The partially absorbable ArtisynY shape mesh use in laparoscopic sacral colpopexy can not only reach the anatomical replacement satage but significantly improve the postoperative quality of life with high subjective and objective cure rate and few mesh erosion condition and foreign body reaction.The partially absorbable Artisyn-Y shape mesh is a reasonable choice for the LSC treatment of pelvic organ prolapse.

关 键 词：盆腔器官脱垂 部分可吸收网片 腹腔镜下阴道骶骨固定术 

分 类 号：R711.2[医药卫生—妇产科学]