Ⅰ水平重建防治腹腔镜全子宫切除术后盆底功能障碍的临床价值  

Clinical study of Ⅰ horizontal reconstruction and reinforcement on prevention and treatment of pelvic floor dysfunction after laparoscopic hysterectomy

作　　者：罗莉[1] 温情[1] LUO Li;WEN Qing(Department of Gynecology,Dazhu People's Hospital Affiliated to North Sichuan Medical College,Dazhou 635199,China)

机构地区：[1]川北医学院附属大竹人民医院妇科,四川达州635199

出　　处：《腹腔镜外科杂志》2022年第3期215-219,共5页Journal of Laparoscopic Surgery

基　　金：达州市科研项目(2019057)。

摘　　要：目的:探讨Ⅰ水平重建加固对防治腹腔镜全子宫切除术后盆底功能障碍的临床价值。方法:选取2019年9月至2020年9月行腹腔镜全子宫切除术的180例患者,根据盆腔脏器脱垂定量标准分为两组,每组90例,A组患者不伴有盆腔脏器脱垂,B组伴Ⅰ度盆腔脏器脱垂;A、B两组再根据阴道残端缝合方式各分为3组,对照A组(n=30)采用传统阴道残端缝合,对照B组(n=30)采用传统阴道残端悬吊,研究组(n=30)采用Ⅰ水平重建加固缝合。比较各组术前及术后3个月、6个月、12个月盆腔脏器脱垂定量分度、盆底障碍、性生活质量、尿失禁发生率。结果:术后3、6、12个月,A、B两组中研究组的盆腔脏器脱垂定量分度均优于对照A组、对照B组(P<0.05);盆底功能障碍评分均低于对照A组、对照B组(P<0.05);性生活质量均高于对照A组、对照B组(P<0.05);尿失禁率均低于对照A组、对照B组(P<0.05)。结论:改良阴道支撑Ⅰ水平重建加固缝合方式较传统方式显著降低了术后盆底功能障碍及尿失禁发生率,患者生活质量明显提高。Objective:To investigate the effect ofⅠhorizontal reconstruction and reinforcement on prevention and treatment of pelvic floor dysfunction after laparoscopic hysterectomy.Methods:One hundred and eighty patients who underwent laparoscopic hysterectomy from Sep.2019 to Sep.2020 were selected and divided into groups A and B with 90 cases in each group according to pelvic organ prolapse quantitation(POP-Q)standard.Group A was not accompanied by pelvic organ prolapse,and group B was accompanied by degreeⅠpelvic organ prolapse.At the same time,the group A and B were randomly divided into three groups according to the suture method of vaginal stump.30 cases in the control group A received traditional vaginal stump suture,30 cases in the control group B underwent traditional vaginal stump suspension,and 30 cases in the study group were sutured with improved vaginal supportⅠhorizontal reconstruction and reinforcement.The POP-Q scores,pelvic floor dysfunction,quality of sexual life,and incidence of urinary incontinence in each group were compared before operation and in 3 months,6 months and 12 months after operation.Results:The POP-Q score of the study group was superior to that of the control group A and B at 3 months,6 months and 12 months after operation in both group A and B,and the difference was statistically significant(P<0.05).Pelvic floor dysfunction score in study group was lower than that in control group A and control group B in 3 months,6 months and 12 months after operation in both group A and B,and the difference was statistically significant(P<0.05).The quality of sexual life in study group was higher than that in control group A and control group B in 3 months,6 months and 12 months after operation in both group A and B,and the difference was statistically significant(P<0.05).The rate of urinary incontinence in study group was lower than that in control group A and control group B in 3 months,6 months and 12 months after operation in both group A and B,and the difference was statistically significan

关 键 词：子宫切除术 腹腔镜检查 Ⅰ水平重建加固 盆底功能障碍 

分 类 号：R713.42[医药卫生—妇产科学]