腹腔镜下全子宫切除同时高位骶韧带悬吊对预防术后盆腔脏器脱垂的意义  

The significance of laparoscopic total hysterectomy with high sacral ligament suspension in preventing pelvic organ prolapse after operation

作　　者：周亚丽[1] 许红[1] 廖红云 栗琼[1] 李燕雄[1] 段毅群 杨硕[1] 冯子豪[1] 管毓坚[1] Zhou Yali;Xu Hong;Liao Hongyun;Li Qiong;Li Yanxiong;Duan Yiqun;Yang Shuo;Feng Zihao;Guan Yujian(Department of Gynecology,First People's Hospital,Kunming City,Kunming,Yunnan,650011,China)

机构地区：[1]云南省昆明市第一人民医院妇科

出　　处：《当代医学》2019年第32期85-88,共4页Contemporary Medicine

基　　金：2018年云南省昆明市西山区科技计划医学重点项目(西科字29号)

摘　　要：目的分析腹腔镜下全子宫切除同时使用高位骶韧带悬吊护理预防术后盆腔脏器脱垂的作用。方法选取2018年4月至2018年8月本院收治的因子宫或附件良性病变需行腹腔镜下全子宫切除同时伴有轻度POP患者为研究对象,按照盆腔器官脱垂定量(POP-Q)分度法对盆腔脏器进行分度,随机分为研究组和对照组,对比两组预防效果。结果研究组手术前后Aa、Ba、Ap、C点位置比较差异有统计学意义(P<0.05),阴道总长度(TVL)比较差异无统计学意义;对照组手术前后Bp、C点位置变化差异无统计意义,TVL比较差异具有统计学意义(P=0.000);研究组TVL手术前后改变(-0.28±0.63)cm,对照组为(1.10±0.43)cm,组间比较差异有统计学意义(P=0.000);研究组阴道前后壁术后解剖复位率高于对照组,差异有统计学意义(P<0.05)。结论高位骶韧带悬吊术可作为预防子宫切除同时伴有轻度POP或POP高危因素患者术后发生POP的首选术式,值得应用。Objective To analyze the effect of high sacral ligament suspension on the prevention of pelvic organ prolapse after laparoscopic total hysterectomy.Methods Laparoscopic total hysterectomy with mild POP was used for screening benign uterine or accessory lesions from April 2018 to August 2018.The pelvic organ was divided according to the POP-Q method,they were random divided into study group and control group to compare the preventive effects.Results The position of Aa,Ba,Ap,and C points before and after the surgery of the study group was relatively different and statistically significant(P<0.05),there was no statistical difference in the total length of the vagina(TVL).The position of Bp and C points in the control group changed before and after the operation was no statistical significance,and TVL had a statistical difference(P=0.000).The change of before and after TVL surgery in the study group was(-0.28±0.63)cm and(1.10±0.43)cm in the control group were statistically significant(P=0.000).The post-operative anatomic reduction rate of the anterior and posterior vaginal wall of the study group was higher than that of the control group and was statistically significant(P<0.05).Conclusion The upper sacral ligament suspension can be used as the first choice for preventing preoperative POP in patients with hysterectomy accompanied by mild POP or POP risk factors.

关 键 词：腹腔镜 全子宫切除 高位骶韧带悬吊 术后盆腔脏器脱垂 

分 类 号：R71[医药卫生—妇产科学]