腹腔镜下子宫悬吊术与阴式全子宫切除合并骶棘韧带悬吊术治疗盆腔器官脱垂的术后疗效比较  

Comparison of Postoperative Clinical Effect Laparoscopic Uterine Suspension and Total Vaginal Hysterectomy with Sacrospinous Ligament Fixation

作　　者：孙熠璇 祝红霞 SUN Yixuan;ZHU Hongxia(Department of Gynecology,The International Peace Maternal and Child Health Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai Key Laboratory of Embryo Original Diseases,Shanghai 200030,China)

机构地区：[1]上海交通大学医学院附属国际和平妇幼保健院妇科,上海市胚胎源性疾病重点实验室,上海200030

出　　处：《实用妇产科杂志》2021年第1期57-61,共5页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨盆腔器官脱垂(POP)患者在接受腹腔镜下子宫悬吊术(LUS)或阴式全子宫切除术合并骶棘韧带悬吊术(TVH-SSLF)后的疗效。方法:共纳入符合条件接受手术的POP患者共86例,43例接受LUS术(LUS组),43例接受TVH-SSLF术(TVH-SSLF组);对比分析两组手术时间、术中出血量、住院时间、生活质量评分。采用PFIQ-7量表及PFDI-20量表进行评估调查。结果:所有患者手术顺利完成。LUS组患者失血量(47.44±29.12 ml)显著低于TVH-SSLF组(62.33±22.34 ml)(P<0.05);两组手术时间[75(65,90)分钟vs 75(65,80)分钟]、住院时间[6(6,7)天vs 6(5,7)天]差异无统计学意义(P>0.05)。PFDI-20术前与术后各分值比较差异有统计学意义(P<0.05)。两组PFDI-20问卷仅术后3个月的POPDI-6中LUS组得分均值(0.047±0.138分)显著高于TVH-SSLF组(0.004±0.025分)(P<0.05)。除此之外,两组术前、术后1个月、3个月、6个月的其他各分类项及总分比较,差异均无统计学意义(P>0.05)。PFIQ-7问卷除了第7个问题“挫折感”的肠道直肠症状TVH-SSLF组得分显著高于LUS组(0.090±0.294分vs 0.000±0.000分,P<0.05)外,其他各分类项以及总评分比较,差异均无统计学意义(P>0.05)。结论:LUS在术后恢复和症状改善上与TVH-SSLF无明显差异,对于有子宫保留意愿、无妇科恶性肿瘤的患者是一个安全、更优的选择。Objective:To assess the improvement of postoperative clinical effect among patients with POP(pelvic organ prolapse)after surgical treatment of laparoscopic uterine suspension(LUS)or total vaginal hysterectomy with sacrospinous ligament fixation(TVH-SSLF).Methods:A total of 86 patients who met the criteria have been included in this research.Forty-three patients underwent LUS(LUS group)while 43 patients experienced TVH-SSLF(TVH-SSLF group).The operation time,intraoperative blood loss,length of hospitalization,quality of life(QoL)were compared between two groups.PFIQ-7 and PFDI-20 scores were applied to assess the quality of life.Results:All the operations were completed successfully.The intraoperative blood loss in LUS group(47.44±29.12 ml)was less than TVH-SSLF group(62.33±22.34 ml)(P<0.05).There was no significant difference in terms of operation time[75(65,90)mins vs.75(65,80)mins,P>0.05]and length of hospitalization[6(6,7)d vs.6(5,7)d,P>0.05].The quality of life has tremendously increased in both groups(P<0.05).In section POPDI-6 of PFDI-20,LUS group showed a higher 3-months post-operative average score(0.047±0.138)than TVH-SSLF group(0.004±0.025)(P<0.05).Whereas,there were no differences in other sections between the two groups among pre-operative and 1-month,3-months,6-months post-operative scores in PFDI-20(P>0.05).In PFIQ-7,the term of“Bowel or rectum symptoms”in Question 7“Feeling frustrated”presented a higher average score in TVH-SSLF than LUS group(0.090±0.294 vs.0.000±0.000,P<0.05),while the other scores showed no difference(P>0.05).Conclusions:The post-operative quality of life showed no difference between two groups.LUS seems to be a beneficial choice for those patients with uterine preservation intention and without gynecological malignant tumor.

关 键 词：盆腔器官脱垂 腹腔镜下子宫悬吊术 阴式全子宫切除术 骶棘韧带悬吊术 

分 类 号：R711.2[医药卫生—妇产科学]