保留子宫阴道前后壁修补术治疗POP的疗效分析  

Therapeutic effect of colporrhaphia anterior-posterior preserving uterus surgery for pelvic organ prolapse

作　　者：许汴菊 刘阳[1] 李娜[1] XU Bianju;LIU Yang;LI Na(Department of Gynecology and Obstetrics,The First Yulin Municipal Hospital,Shaanxi Yulin 719000,China)

机构地区：[1]榆林市第一医院妇产科,陕西榆林719000

出　　处：《中国妇幼健康研究》2020年第9期1263-1267,共5页Chinese Journal of Woman and Child Health Research

摘　　要：目的将保留子宫的阴道前后壁联合修补手术应用于中重度盆腔器官脱垂(POP)患者的治疗,分析相关病例资料并探讨其临床应用价值。方法将榆林市第一医院妇产科2015年1月至2018年1月诊治的中重度POP患者作为研究对象,根据手术方法分为两组:保留子宫组(n=44,采用保留子宫的阴道前后壁联合修补术)和对照组(n=41,采用子宫切除+阴道壁修补术),记录并比较两组病例围手术期相关指标、生活质量和复发情况。结果保留子宫组比对照组的手术时间更短[(75.31±29.02)min vs.(91.44±37.18)min,t=2.239,P<0.05]、手术出血量更少[(58.4±25.30)mL vs.(83.47±32.91)mL,t=3.950,P<0.05]、术后留置尿管时间更短[(2.10±0.89)天vs.(2.59±0.97)天,t=2.429,P<0.05],且治疗费用更少[(8 658.40±1 733.19)元vs.(10 930.06±2 261.83)元,t=5.219,P<0.05]、术后阴道长度更长[(6.39±1.51)cm vs.(5.03±1.14)cm,t=4.660,P<0.05]。术后1年:保留子宫组盆底功能障碍影响简易问卷(PFIQ-7)评分高于对照组[(31.87±3.98) vs.(28.31±3.22),t=4.514,P<0.05],性生活质量问卷(PISQ-12)评分高于对照组[(76.46±11.80) vs.(63.07±10.21),t=5.576,P<0.05]。两组复发率比较差异无统计学意义(P>0.05)。结论保留子宫的阴道前后壁联合修补术治疗POP手术时间短、术中出血少、恢复快、疗效确切且花费少,术后阴道长度满意、对性功能影响小。Objective To observe therapeutic effect of uterus-preserving surgery of colporrhaphia anterior-posterior for pelvic organ prolapse(POP),and to explore clinical application value of the procedure.Methods The patients with moderate/severe POP who were treated in department of gynecology and obstetrics in our hospital from January 2015 to January 2018 were selected as the subjects of study.They were divided into two groups according to operation method:uterus-preserving colporrhaphia anterior-posterior surgery group(uterus-preserving group in simple,n=44) and hysterectomy plus repair of vaginal wall group(control group,n=41).The perioperative observation indexes,quality of life and recurrence were recorded and compared between the two groups.Results Compared with those patients in the control group,the patients in the uterus-preserving group had shorter operation time(75.31±29.02 min vs 91.44±37.18 min,t=2.239,P<0.05),less intraoperative bleeding amount(58.42±25.30 ml vs 83.47±32.91 ml,t=3.950,P<0.05),shorter postoperative catheter indwelling time(2.10±0.89 d vs 2.59±0.97 d,t=2.429,P<0.05),less treatment cost(8658.40±1733.19 yuan RMB vs 10930.06±2261.83 yuan RMB,t=5.219,P<0.05),and longer residual vaginal length following the operation(6.39±1.51 cm vs 5.03±1.14 cm,t=4.660,P<0.05).At 12 months after operation,pelvic floor influence questionnaire-7(PFIQ-7) score of the patients in the uterus-preserving group was higher than that in the control group(31.87±3.98 vs 28.31±3.22, t=4.514,P<0.05) and PISQ-12 score of the patients was also higher(76.46±11.80 vs 63.07±10.21,t=5.576,P<0.05).Conclusion Compared with traditional methods,the colporrhaphia anterior-posterior surgery with uterus preservation for POP has some advantages such as shorter operation time,less intraoperative bleeding amount,quick recovery and low cost.The length of the residual vagina after operation is satisfactory and influence of the operation on sexual function of the patient is less.

关 键 词：盆腔器官脱垂 阴道前后壁修补 阴式手术 保留子宫 生活质量 

分 类 号：R713[医药卫生—妇产科学]