改良阴道后壁修补术和阴道后壁环肌紧缩术治疗产后阴道松弛的效果比较  

Effects of modified vaginal posterior-wall repair surgery and vaginal posterior-wall circular muscle constriction surgery on postpartum vaginal relaxation

作　　者：娄艳红 王军杰 刘岩 李佳佳 郭冰冰 Lou Yanhong;Wang Junjie;Liu Yan;Li Jiajia;Guo Bingbing(Department of Plastic Surgery,Henan Provincial Third People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省直第三人民医院整形外科,郑州450000

出　　处：《中国实用医刊》2020年第23期90-93,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较改良阴道后壁修补术和阴道后壁环肌紧缩术治疗产后阴道松弛的效果。方法回顾性分析2017年12月至2019年12月河南省直第三人民医院收治的204例产后阴道松弛患者的临床资料,并根据治疗方法分为对照组(阴道后壁环肌紧缩术)100例和观察组(改良阴道后壁修补术)104例。比较两组围术期指标,记录其术前、术后6个月阴道松紧度、性生活满意度[采用性生活质量调查表(SLQQ)评估]及术后6个月的盆底肌功能变化情况,并通过观察患者住院期间的相关并发症发生情况评估其安全性。结果两组患者术中出血量、手术切口长度、手术时间比较差异未见统计学意义(P>0.05)。术后6个月,观察组阴道松紧度分级优于对照组(P<0.05)。术后6个月,两组患者SLQQ量表各维度评分及总分均较术前提升(P均<0.05),且观察组高于对照组(P<0.05)。术后6个月,两组患者盆底肌力等级分级比较差异有统计学意义(P<0.05)。住院期间,两组患者阴道残端愈合不良、阴道壁血肿、尿道损伤、感染发生率比较差异未见统计学意义(P>0.05)。结论改良阴道后壁修补术和阴道后壁环肌紧缩术治疗产后阴道松弛的近期疗效相当,且并发症发生率较低,安全性高,但前者远期疗效更好,更有利于患者盆底肌功能及阴道松紧度恢复,进而提高性生活满意度。Objective To observe the efficacy of modified vaginal posterior-wall repair surgery and vaginal posterior-wall circular muscle constriction surgery in the treatment of postpartum vaginal relaxation.Methods The clinical data of 204 patients with postpartum vaginal relaxation in Henan Provincial Third People’s Hospital from December 2017 to December 2019 were retrospectively analyzed.According to the treatment methods,the patients were divided into control group(100 cases,treated by posterior vaginal wall ring muscle tightening)and observation group(104 cases,treated by modified vaginal posterior wall repair).The perioperative indicators were compared between the two groups.Preoperative and 6-month postoperative vaginal tightness,sexual life satisfaction assessed by Sexual Life Quality Questionnaire(SLQQ),and pelvic floor muscle function 6 months after surgery were compared between the two groups.The incidences of related complications during hospitalization were observed to evaluate the safety.Results There were no statistically significant differences in the intraoperative blood loss,surgical incision length or operative time between the two groups(P>0.05).At 6 months after surgery,the vaginal tightness classification in observation group was significantly better than that in control group(P<0.05).At 6 months after surgery,the scores of dimensions and total score of SLQQ scale in the two groups were improved compared with those before surgery(all P<0.05),and observation group had higher scores than control group(P<0.05).At 6 months after surgery,there was a statistically significant difference in the pelvic floor muscle strength classification between the two groups(P<0.05).During hospitalization,there were no statistically significant differences in the incidences of poor vaginal stump healing,vaginal wall hematoma,urethral injury,or infection between the two groups(P>0.05).Conclusions Modified posterior vaginal-wall repair surgery and posterior vaginal-wall circular muscle constriction surgery have similar sh

关 键 词：改良阴道后壁修补术 阴道后壁环肌紧缩术 产后阴道松弛 疗效 

分 类 号：R713.31[医药卫生—妇产科学]