经阴道骶棘韧带悬吊术治疗盆腔器官脱垂的疗效及盆底功能改善情况  

Transvaginal sacrospinous ligament suspension for the treatment of pelvic organ prolapse and improvement of pelvic floor function

作　　者：李善凤[1] 孙姣 温道清[1] 孙文静 LI Shan-Feng;SUN Jiao;WEN Dao-Qing(Department of Obstetrics and Gynecology,Lianyungang Maternal and Child Health Hospital,Lianyungang,Jiangsu 222000,China)

机构地区：[1]连云港市妇幼保健院妇产科,江苏连云港222006

出　　处：《中国妇幼保健》2021年第24期5622-5625,共4页Maternal and Child Health Care of China

基　　金：江苏省老年健康科研项目(LK2021048)。

摘　　要：目的探讨盆腔器官脱垂患者实施经阴道骶棘韧带悬吊术治疗的临床效果和盆底功能改善情况。方法选取2015年1月—2018年3月江苏省连云港市妇幼保健院收治的中重度盆腔器官脱垂患者144例,根据随机数字表法将其分为观察组72例与对照组72例,观察组给予阴式子宫切除术+经阴道骶棘韧带悬吊术治疗,对照组给予传统阴式子宫切除术+阴道前后壁修补术。对两种患者围手术期相关指标、手术后盆底功能改善情况、术后并发症及复发率等进行观察比较。结果在围手术期指标方面,观察组手术时间(82.47±10.94)min与对照组(161.34±11.22)min比较明显缩短,观察组术后住院时间(11.31±1.52)d与对照组(17.23±0.44)d比较明显缩短,观察组术中出血量(124.73±32.17)ml与对照组(194.31±22.31)ml比较明显减少,差异均有统计学意义(均P<0.05);在术后并发症方面,观察组总发生率4.17%与对照组总发生率20.83%比较明显降低,差异有统计学意义(P<0.05);治疗后1个月、1年及3年PFIQ-7评分和PFDI-20评分均较治疗前显著降低,与对照组比较,观察降低程度更显著(均P<0.05);在POP-Q各指示点(Aa、Ba、Ap、Bp及C)测量值方面,术前两组间各指示点测量比较差异无显著性,术后1个月、1年及3年两组各指示点测量值明显降低,差异有统计学意义(P<0.05)。在复发率方面,观察组总发生率5.56%较对照组29.17%明显降低,差异有统计学意义(P<0.05)。结论对盆腔器官脱垂患者实施经阴道骶棘韧带悬吊术治疗能够取得良好的临床效果,术后盆底功能改善明显,并发症少,复发率低,疗效安全可靠,可进一步临床推广。Objective To perform transvaginal sacrospinous ligament suspension treatment for patients with pelvic organ prolapse and analyze its clinical effect and improvement of pelvic floor function.Methods 144 patients with moderate to severe pelvic organ prolapse who were admitted to the hospital from June 2017 to June 2019 were selected and divided into an observation group(72 case)and a control group(72 case)according to random number table The observation group was treated with transvaginal sacrospinous ligament suspension,and the control group was treated with traditional vaginal hysterectomy.The perioperative indicators of the two patients,the improvement of pelvic floor function before and after operation,postoperative complications and recurrence rate were observed and compared.Results The time of operation in the observation group was significantly shorter than that in the Control Group[(82.47±10.94)minutes vs.(161.34±11.22)minutes,(11.31±1.52)days vs.(17.23±0.44)days].The intraoperative bleeding volume in the observation group was(124.73±32.17)ml,and that in the control group was(194.31±22.31)ml.The differences were statisticallysignificant(P<0.05);The incidence rate of 4.17%was significantly lower than the total incidence rate of the control group of 20.83%(P<0.05);in terms of pelvic floor function improvement,the PFIQ-7 scores of the two groups were 1 month,1 year,and 3 years after treatment,PFDI-20 scores were significantly lower than before treatment,of which the observation group was significantly lower than the control group,the difference was statistically significant(P<0.05);at the POP-Q indicator points(Aa,Ba,Ap,Bp,C)In terms of measured values,there was no significant difference in the measured values of the indicator points between the two groups before the operation,and the measured values of the indicator points of the two groups decreased significantly at 1 month,1 year,and 3 years after the operation,of which the observation group and the control group The decrease in comparison is more sig

关 键 词：经阴道骶棘韧带悬吊术 盆腔器官脱垂 疗效 盆底功能 

分 类 号：R713[医药卫生—妇产科学]