腹腔镜骶骨固定术相关并发症的回顾:7年单中心临床分析  

Complications associated with laparoscopic sacral fixation:a 7-year single center clinical analysis

作　　者：赵成志 卢深涛 王荥[1] 刘明博[1] 孙玉菡[1] 雷丽[1] 刘禄斌[1] Zhao Chengzhi;Lu Shentao;Wang Ying;Liu Mingbo;Sun Yuhan;Lei Li;Liu Lubin(Gynecology Pelvic Floor and Oncology Department Chongqing Maternal and Child Health Hospital,Chongqing 400021, China)

机构地区：[1]重庆市妇幼保健院妇科盆底与肿瘤科,400021

出　　处：《中华腔镜外科杂志（电子版）》2020年第4期223-228,共6页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

基　　金：重庆市自然科学基金(cstc2019jcyj-msxm0877);重庆市技术创新与应用示范(社会民生类一般)项目(cstc2018jscx-msyb0800)。

摘　　要：目的回顾性分析重庆市妇幼保健院行腹腔镜骶骨固定术7年的临床资料,分析总结该术式的相关并发症及处理。方法收集2012年1月至2019年11月接受腹腔镜骶骨固定术的238例患者的临床随访资料,统计分析手术前后POP-Q的Ba、Bp、C、D位点等各指示点及生存质量和性生活状态评分的变化,术后各类并发症的处理情况。结果腹腔镜骶骨固定术治疗中盆腔缺陷的有效方式,其治愈率为98.74%;Ba、Bp、C、D位点,以及PFDI-20和PISQ-12问卷均有明显改善,术后生存质量及性生活状态改善。术后的并发症发生率约15.55%,其中便秘发生率最高(约5.04%),其次为疼痛3.78%,网片暴露、新发尿失禁、骶前出血、尿潴留的发生率均1.26%;复发、严重感染发生率0.84%,性生活障碍、输尿管折叠梗阻、尿道损伤发生率0.42%;所有并发症均经相应处理治愈。结论腹腔镜骶骨固定术是治疗中盆腔缺陷的有效方式,效果满意,但需重视手术网片并发症的预防及处理,对并发症的合理治疗可以改善患者的预后。Objective To analyze the clinical data of laparoscopic sacral fixation in our hospital for 7 years,analyze and summarize the related complications and treatment.Methods The clinical follow-up data of 238 patients who underwent laparoscopic sacral fixation from Jan.2012 to Nov.2019 in the department of gynecology and pelvic floor and oncology of Chongqing maternal and child health hospital were collected,and the changes of Ba,Bp,C,D and other indicators of POP-Q before and after the operation,the quality of life and the score of sexual activity,and the treatment of various complications and complications after the operation were statistically analyzed.Result Laparoscopic sacral fixation can treat pelvic organ prolapse with pelvic cavity defects,and the quality of life and sexual life improved after operation.The cure rate of all patients receiving sacral fixation is 98.74%,and the incidence of complications is about 15.55%.The incidence of constipation is about 5.04%,followed by pain,3.78%,net exposure,new urinary incontinence,presacral bleeding and urinary retention.The incidence of recurrence and serious infection was 0.84%,sexual life disorder,ureteral fold obstruction and urethral injury was 0.42%,all complications were cured.Conclusions Laparoscopic sacral fixation is an effective method for the treatment of pelvic defects.There are corresponding complications of operation and mesh.Reasonable treatment can improve the prognosis of patients.

关 键 词：盆腔器官脱垂 腹腔镜骶骨固定术 网片 术后并发症 治疗 

分 类 号：R47[医药卫生—护理学]