阴道残端圆韧带悬吊术对腹腔镜全子宫切除术后患者盆底功能的影响  

Effect of vaginal stump round ligament suspension on the pelvic floor function in patients undergoing total laparoscopic hysterectomy

作　　者：潘琦文[1] 黄春绘 李建湘[1] 陆国华 韦飞迎 PAN Qiwen;HUANG Chunhui;LI Jianxiang;LU Guohua;WEI Feiying(Department of Gynecology,the People’s Hospital of Hechi,Guangxi,Hechi 547000,China)

机构地区：[1]广西壮族自治区河池市人民医院妇科,广西河池547000

出　　处：《中国医药科学》2022年第4期84-87,99,共5页China Medicine And Pharmacy

基　　金：广西壮族自治区河池市科学研究与技术开发计划项目(河科B1824-8)。

摘　　要：目的分析阴道残端圆韧带悬吊术对腹腔镜全子宫切除患者术后盆底功能的影响。方法选取河池市人民医院2017年1月至2018年6月收治的400例腹腔镜全子宫切除患者作为研究对象,根据随机数字表法分为两组,常规手术组200例行常规腹腔镜下全子宫切除术+残端左右缝合,残端悬吊组200例行腹腔镜全子宫切除术+阴道残端侧对侧缝合+同侧圆韧带悬吊术。比较两组患者手术情况,术后随访3~36个月,比较两组患者性生活质量、盆底肌肉肌力以及压力性尿失禁、阴道顶端脱垂发生率。结果术后3、12、36个月,残端悬吊组中国女性性生活质量问卷评分均明显高于常规手术组(P<0.05)。残端悬吊组压力性尿失禁、阴道顶端脱垂发生率均明显低于常规手术组(P<0.05)。残端悬吊组盆底肌肉肌力明显高于常规手术组(P<0.05)。结论阴道残端圆韧带悬吊术能有效保护腹腔镜全子宫切除术后患者的盆底功能,减轻对性生活的影响,降低阴道顶端脱垂以及压力性尿失禁发生率,不增加患者医疗费用,值得临床推广。Objective To analyze the effect of vaginal stump round ligament suspension(RLS)on the pelvic floor function in patients undergoing total laparoscopic hysterectomy(TLH).Methods A total of 400 patients undergoing TLH admitted to the People’s Hospital of Hechi from January 2017 to June 2018 were selected as study subjects and divided into two groups according to the random number table method.200 patients in the conventional surgery group underwent conventional TLH+left-right suture of the stump,while 200 patients in the stump suspension group underwent TLH+side-to-side suture of the vaginal stump+ipsilateral RLS.The surgery condition,the sexual quality of life,muscle strength of pelvic floor muscles,and the incidences of stress urinary incontinence and vaginal vault prolapse at 3-36 months follow-up after surgery were compared between the two groups.Results At 3,12 and 36 months after surgery,the scores of the Sexual Quality of Life Questionnaire for Chinese Women in the stump suspension group were significantly higher than those in the conventional surgery group(P<0.05).The incidences of stress urinary incontinence and vaginal vault prolapse in the stump suspension group were significantly lower than those in the conventional surgery group(P<0.05).The muscle strength of pelvic floor muscles in the stump suspension group was significantly higher than that in the conventional surgery group(P<0.05).Conclusion Vaginal stump RLS can effectively protect the pelvic floor function,reduce the impact on sexual life,and lower the incidences of vaginal vault prolapse and stress urinary incontinence in patients undergoing TLH,without increasing medical costs.Therefore,it is worthy of clinical promotion.

关 键 词：腹腔镜全子宫切除术 阴道残端侧对侧缝合 同侧圆韧带悬吊术 盆底功能 

分 类 号：R737.33[医药卫生—肿瘤]