盆底重建术中3种骶棘韧带固定术临床效果评价  

Evaluation of clinical effects of three kinds of sacrospinous ligament fixation in the pelvic floor reconstruction

作　　者：孙玉菡[1] 卢深涛 雷丽[1] 刘禄斌[1] SUN Yu-han;LU Shen-tao;LEI Li;LIU Lu-bin(Department of Gynecological Pelvic Floor and Oncology,Chongqing Health Center for Women and Children,Chongqing 401120,China)

机构地区：[1]重庆市妇幼保健院妇科盆底与肿瘤科,重庆401120

出　　处：《中国实用妇科与产科杂志》2020年第12期1192-1195,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家自然科学基金(81671441);重庆市科委创新与应用示范项目(cstc2018jscx-msybX0083)。

摘　　要：目的比较经阴道单侧骶棘韧带固定术(USSLF)、双侧骶棘韧带固定术(BSSLF)及结合网片的双侧骶棘韧带吊带固定术(MSSLF)在治疗中、重度中盆腔器官脱垂的临床疗效。方法选择重庆市妇幼保健院2014年2月至2017年11月收治的中盆腔器官脱垂Ⅱ度或Ⅱ度以上且有手术意愿的患者88例,分为3组:经阴道USSLF 32例(单侧组)、经阴道BSSLF 22例(双侧组)及经阴道MSSLF 34例(网片组)。比较3组患者的术中、术后的各项指标及疗效。结果3组患者术前与术后Aa、Ba、C、Ap、Bp、PFDI-20评分比较,差异均有统计学意义(P<0.05)。网片组复发率最低,但3组患者复发率差异无统计学意义(P>0.05)。网片组术后C点较单侧组低(P<0.05),网片组术后PFDI-20评分较双侧组低(P<0.05)。结论3种方式均是治疗中、重度中盆腔器官脱垂的有效方式。USSLF并发症少,但复发率相对较高;BSSLF对患者的生活质量影响相对较大,采用时需慎重;MSSLF复发率最低,对生活质量影响小,但存在网片暴露可能,熟练掌握后,是值得推荐的手术方式。Objective Comparing the clinical curative effect of the unilateral sacrospinous ligament fixation(USSLF)and the transvaginal bilateral sacrospinous ligament fixation(BSSLF)and bilateral sacrospinous ligament fixation with mesh(MSSLF)in the treatment of moderate and severe pelvic organ prolapse.Methods A total 88 patients with pelvic prolapse(gradeⅡor above)who were willing to receive operation were selected and divided into three groups.They were treated by transvaginal USSLF(unilateral group),transvaginal BSSLF(bilateral group)and transvaginal MSSLF(mesh group)respectively.The indexes and the curative effect in three groups during and after the operation were compared.Results There was significant difference in Aa,Ba,C,Ap,Bp,PFDI-20 score between before and after operation in the three groups(P<0.05).The recurrence rate was the lowest in the mesh group,but there was no significant difference in the recurrence rate among the three groups(P>0.05).The C point of the mesh group was lower than that of the unilateral group,and the PFDI-20 score of the mesh group was lower than that of the bilateral group(P<0.05).Conclusion All these three surgical methods are effective in the treatment of moderate and severe pelvic organ prolapse.There are few complications in USSLF,but the recurrence rate is relatively high.BSSLF greatly impairs the life quality of patients and should be adopted with caution.The recurrence rate of MSSLF is the lowest and the influence on the life quality of patients is small,but there is the possibility of mesh exposure,and it is the most recommended surgical method if we can master it skillfully.

关 键 词：骶棘韧带固定术 子宫脱垂 盆腔器官脱垂 聚乙烯网片 

分 类 号：R713[医药卫生—妇产科学]