腹腔镜下线性阴道悬吊术应用于脱垂子宫切除术的价值  

Clinical Value of Laparoscopic Linear Vaginal Suspension in Prolapsed Hysterectomy

作　　者：刘敏 邱伟 黄艳 吴土连 LIU Min;QIU Wei;HUANG Yan;WU Tulian(Gaozhou Hospital of Traditional Chinese Medicine,Gaozhou 525200,China)

机构地区：[1]高州市中医院

出　　处：《现代医院》2019年第11期1667-1670,共4页Modern Hospitals

摘　　要：目的探究腹腔镜下线性阴道悬吊术应用于脱垂子宫切除术预防阴道穹窿脱垂的治疗效果。方法回顾性分析2016年1月—2017年12月收治的盆腔脏器脱垂Ⅲ~Ⅳ度、以中盆腔脱垂为主的患者,共49例,采用患者知情同意自愿选择的方式随机分为研究组和传统组,其中研究组26人,传统组23人,传统组行经阴道全子宫切除术(伴有阴道前后壁膨出者同时行阴道前后壁修补术),研究组在传统组的基础上行腹腔镜下经腹膜外前腹壁线性阴道悬吊术。比较两组患者手术时间、术中出血量、术后留置尿管时间、术后住院时间、住院总费用、术后阴道位置、术后生活质量。结果术后随访1年研究组复发率较传统组低;两组患者术后阴道位置差异有统计学意义(P<0.05),研究组POP-Q分度中的C点位置较传统组的高;两组患者术后生活质量差异有统计学意义(P<0.05),研究组术后6个月及术后1年的PFIQ-7评分较低,生活质量较高;两组患者术后性生活质量差异有统计学意义(P<0.05),研究组PISQ-12评分较高,性生活质量较高。两组患者的术后留置尿管时间、术后住院时间无明显差异;手术时间、术中出血量、住院总费用均有差异,但差异未影响该手术的可接受性。结论腹腔镜下线性阴道悬吊术应用于脱垂子宫切除术能有效预防术后阴道穹窿脱垂,该术式可行、安全、有效,性价比高,值得推广。Objective To investigate the therapeutic effect of laparoscopic linear vaginal suspension in the prevention of vaginal fornix prolapse after prolapsed hysterectomy.Methods A retrospective analysis was done on the records of 49 cases with pelvic organ prolapse of Ⅲ to Ⅳ degree in our hospital from January in 2016 to December in 2017Based on their voluntary consents with informed consent,they were randomized into study group and traditional group,26 in the study group and 23 in the traditional group.The traditional group underwent transvaginal hysterectomy(repair of anterior and posterior vaginal wall simultaneously in patients with anterior and posterior vaginal wall bulge.)The patients in the study group underwent laparoscopic transperitoneal anterior abdominal wall linear vaginal suspension on the basis of the traditional group.The operation time,intraoperative bleeding volume,postoperative indwelling catheter time,postoperative hospitalization time,total cost of hospitalization,postoperative vaginal position and postoperative quality of life were compared between the two groups.Results The recurrence rate of the study group was lower than that of the traditional group after 1 year follow-up.There was significant difference in vaginal position between the two groups(P<0.05),and the C-point position of POP-Q in the study group was higher than that in the traditional group.There was significant difference in the quality of life between the two groups(P<0.05),the PFIQ-7 score of the study group was lower and the quality of life was higher 6 months and 1 year after the operation.There was significant difference in the quality of sexual life between the two groups(P<0.05),the PISQ-12 score of the study group was higher and the quality of sexual life was higher.Between the two groups,there was no significant difference in indwelling catheter time and hospitalization time;and there were differences in operation time,intraoperative bleeding volume and total hospitalization expenses.However,the difference did not aff

关 键 词：腹腔镜 子宫脱垂 阴道穹窿脱垂 阴道悬吊术 

分 类 号：R713.3[医药卫生—妇产科学] R713.42[医药卫生—临床医学]