新式经阴道盆腔器官脱垂手术临床研究  

A clinical study of the new vaginal operative treatment for pelvic organ prolapse

作　　者：宋磊[1] 付晓宇[1] 李棪 SONG Lei;FU Xiao-yu;LI Yan(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：《中国实用妇科与产科杂志》2018年第11期1267-1270,共4页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨新式经阴道盆腔器官脱垂手术治疗中重度盆腔器官脱垂(POP)患者的临床疗效、手术要点和临床意义。方法收集1998年12月至2018年1月解放军总医院妇产科接受阴式盆底重建手术治疗中重度盆腔器官脱垂患者1262例,其中采用新式经阴道盆腔器官脱垂手术患者725例为研究组,阴式子宫切除+传统阴道前后壁修补术537例为对照组。比较两组患者基线资料、治疗相关指标和随访疗效及复发情况。结果研究组手术时间[(62.8±18.7)min vs.(83.6±24.3)min]、术中出血量[(67.4±21.6)m L vs.(110.1±51.3)m L]均少于对照组,差异有统计学意义(P<0.05);两组平均住院日[(5.8±2.1)d vs.(6.3±1.7)d]差异无统计学意义(P>0.05)。研究组修补术后阴道长度[(10.3±1.2)cm vs.(8.4±2.2)cm]大于对照组,差异有统计学意义(P<0.05);总复发率低于对照组(4.3%vs. 15.1%,P=0.198)。结论新式经阴道盆腔器官脱垂手术,利用阴道自然腔道治疗盆腔器官脱垂,手术时间短、创伤小、安全、康复快、住院时间短、医疗费用低,无需昂贵手术设备和材料(腹腔镜、网片),经济实用,适用于广大基层医院,亦适用于包括子宫切除术后阴道顶脱垂的各种类型POP。Objective To analyze the clinical effect of the new type of vaginal operative treatment on moderate or severe pelvic organ prolapse（POP）and discuss the key points of operation and its clinical value.Methods A total of 1262 cases of pelvic organ prolapse were selected in the Department of Obstetrics and Gynecology of the PLA General Hospital from December 2008 to January 2018.The observation group（725 cases）was treated with the new type of vaginal operative procedure on POP,and the control group（537 cases）was treated with vaginal hysterectomy plus traditional vaginal wall repair operation.Results The time of operation,the amount of bleeding of the study group were less than those of the control group[（62.8±18.7）min vs.（83.6±24.3）min][（67.4±21.6）ml vs.（110.1±51.3）mL]（P〈0.05）.The length of the vagina in the observation group was greater than that of the control group[（10.3±1.2）cm vs.（8.4±2.2）cm]（P〈0.05）.The total recurrence rate of the observation group was significantly lower than the control group（4.3%vs.15.1%,P=0.198）.The hospitalization time had no significant difference between the observation group and the control group[（5.8±2.1）d vs.（6.3±1.7）d]（P〉0.05）.Conclusion The new type of operative method on moderate or severe POP had shorter operative time,less bleeding,and longer vaginal length.It was easy to master.The short-term curative effect was comparable to that of the pelvic floor reconstruction with hysterectomy and mesh patch.

关 键 词：盆腔器官脱垂 阴道前后壁修补 盆底重建 阴式手术 

分 类 号：R711.2[医药卫生—妇产科学]