阴道后壁桥式修补结合盆底筋膜缝合治疗阴道后壁缺陷的临床疗效观察  

Clinical observation of posterior vaginal wall defects treated by bridge-type repair combined with pelvic fascial suture

作　　者：姚艳 袁琳 刘琦 郑艳 YAO Yan;YUAN Lin;LIU Qi;ZHENG Yan(Obstetrics and Gynecology Department,Hebei Renqiu North China Petroleum General Hospital,Renqiu 062552,Hebei,China)

机构地区：[1]华北石油总医院妇产科,河北任丘062552

出　　处：《中国性科学》2019年第3期95-99,共5页Chinese Journal of Human Sexuality

摘　　要：目的分析阴道后壁桥式修补术结合盆底筋膜缝合治疗阴道后壁缺陷的效果,以及对患者性生活质量的影响,为改进后壁缺陷(阴道后壁脱垂)修补方法提供参考。方法采用回顾性研究,选择2016年3月至2017年2月华北石油总医院诊治的70例阴道后壁缺陷患者为研究对象。按照不同手术方式,将其分为观察组和对照组,每组35例患者。观察组患者行阴道后壁桥式修补结合盆底筋膜缝合;对照组行传统阴道后壁修补术。比较两组患者手术用时、术中出血量、住院时间;采用彭强器官脱垂尿失禁患者性生活调查表(PISQ-12)评估两组患者术前术后性生活质量,记录改善程度;随访1年,记录两组患者恢复情况、并发症发生率和1年复发率。结果①观察组患者手术用时、住院时间均短于对照组患者,术中出血量少于对照组患者,其差异均具有统计学意义(均P=0.0000)。②术前和术后3个月,两组患者PISQ-1评分差异无统计学意义(P>0.05);两组患者PISQ-1评分差值比较,其差异具有统计学意义(P=0.0000)。③两组患者均出现损伤,但随访期间愈合;两组术前便秘患者术后均有所改善且无严重便秘,对照组1例患者轻微尿失禁、阴道变短,观察组患者并发症发生率和1年复发率(5.7%、0%)低于对照组患者(22.9%、11.4%),其差异均具有统计学意义(均P<0.05)。结论阴道后壁桥式修补术结合盆底筋膜缝合能够有效治疗阴道后壁缺陷,改善便秘等症状;与传统术式相比,能够缩短手术用时,促进康复,减少并发症,降低1年复发率,值得推广应用。Objective To analyze the effect of vaginal posterior wall bridge repair combined with pelvic floor fascia suture in the treatment of posterior vaginal wall defects, as well as the impact on the patient's quality of life, to provide reference for the future improvement of the repair of posterior wall defects (vaginal posterior wall prolapse). Methods A retrospective study was conducted to select 70 patients with posterior vaginal wall defects admitted to the North China Petroleum General Hospital from March 2016 to February 2017. According to different surgical methods, they were divided into observation group and control group, with 35 patients in each group. Patients in the observation group underwent vaginal posterior wall bridge repair combined with pelvic floor fascia suture;the control group underwent conventional vaginal posterior wall repair. The time-consuming, blood loss and hospitalization time of the two groups were compared. The sexual life quality of the two groups of patients before and after surgery was evaluated by using the Peng Qeng organ prolapse urinary incontinence patient sexual life questionnaire (PISQ-12). After 1 year of follow-up, the recovery, complication rate and 1-year recurrence rate of the two groups were recorded. Results (J)The patients in the observation group had shorter operation time and hospitalization time than the control group. The blood loss was less than that of the control group, and the difference was statistically significant (all P = 0. 0000).(2)There was no significant difference in PISQ-1 score between the two groups before and 3 months after operation (P >0. 05). The difference of PISQ-1 scores between the two groups was statistically significant (P = 0.0000).(3)Both groups of patients developed injury, but healed during follow-up;both groups of patients with preoperative constipation improved after surgery and no serious constipation, 1 patient in the control group had mild urinary incontinence, vaginal shortening, and complications occurred in the observation g

关 键 词：阴道后壁缺陷 阴道脱垂 阴道后壁桥式修补术 自体组织 

分 类 号：R711[医药卫生—妇产科学]