腹腔镜下圆韧带缩短及阴道残端腹壁悬吊预防子宫切除术后阴道顶端脱垂的临床效果研究  

The clinical effect of shortening the round ligament under laparoscopic surgery and suspending the vaginal stump and abdominal wall to prevent vaginal tip prolapse after hysterectomy

作　　者：未欢 陈芳[1] 胡宗琼[1] 柳先明[2] 陈炜 WEI Huan;CHEN Fang;HU Zongqiong;LIU Xianming;CHEN Wei(Mianyang Maternal and Child Health Hospital,Mianyang,Sichuan 621000,China;Mianyang Cancer Hospital,Mianyang,Sichuan 621000,China;404 Hospital of Mianyang,Mianyang,Sichuan 621000,China)

机构地区：[1]绵阳市妇幼保健院,四川绵阳621000 [2]绵阳市肿瘤医院,四川绵阳621000 [3]绵阳市四零四医院,四川绵阳621000

出　　处：《现代医药卫生》2020年第24期3955-3957,3961,共4页Journal of Modern Medicine & Health

摘　　要：目的研究腹腔镜下圆韧带缩短及阴道残端腹壁悬吊术在子宫脱垂患者子宫全切术后预防阴道顶端脱垂方面的安全性和有效性。方法选取施行腹腔镜全子宫切除术,同时行腹腔镜下圆韧带缩短及阴道残端腹壁悬吊术的子宫脱垂患者28例作为研究对象,对其临床资料进行回顾性分析,通过术前、术后盆腔脏器脱垂评估分类法(POP-Q)分度,阴道穹隆指示点,生活质量,并发症等指标评估手术效果。结果28例患者随访至术后12~19个月。术前POP-Q分度为Ⅱ-Ⅳ度,27例术后POP-Q分度为0度。术后C、D指示点值、阴道顶端活动度绝对值大于术前。手术并发症1例,为腹壁悬吊过紧,拆线后残端脱垂复发POP-Q分度为Ⅰ度。客观治愈率为96.42%。结论腹腔镜下圆韧带缩短及阴道残端腹壁悬吊术在预防子宫脱垂患者子宫切除术后的阴道残端脱垂方面安全可靠,近期疗效明显。Objective To study the safety and effectiveness of laparoscopic round ligament shortening and vaginal stump abdominal wall suspension in preventing vaginal tip prolapse after total hysterectomy in patients with uterine prolapse.Methods Totally 28 patients with uterine prolapse who underwent laparoscopic hysterectomy,laparoscopic round ligament shortening and vaginal stump abdominal wall suspension were selected as the research objects.The clinical data was retrospectively analyzed,and the results of the operation were evaluated by indicators such as preoperative and postoperative POP-Q indexing,vaginal vault indicator points,quality of life,and complications.Results 28 patients were followed up to 12-19 months after operation.The preoperative POP-Q scale of all patients wasⅡ-Ⅳ,and the POP-Q scale of 27 patients was 0 degree after operation.The C and D indicator points after operation and the absolute value of vaginal apex range of motion were greater than those before operation.One case of surgical complications was that the abdominal wall suspension was too tight,and the recurrence of stump prolapse after suture removal was POP-Q grade I.The objective cure rate was 96.42%.Conclusion Laparoscopic round ligament shortening and vaginal stump abdominal wall suspension are safe and reliable in preventing vaginal stump prolapse after hysterectomy in patients with uterine prolapse,and the short-term effect is obvious.

关 键 词：腹腔镜 阴道残端 圆韧带缩短 腹壁悬吊 盆腔器官脱垂 

分 类 号：R713.43[医药卫生—妇产科学]