腹腔镜下腹直肌子宫悬吊术治疗子宫脱垂的临床疗效  

Clinical efficacy of laparoscopic uterine rectus abdominis suspension in the treatment of uterine prolapse

作　　者：鲍明霞 BAO Ming-xia(Department of Obstetrics and Gynecology,Dongyuan County People's Hospital,Heyuan 517500,China)

机构地区：[1]东源县人民医院妇产科,517500

出　　处：《中国实用医药》2022年第13期16-19,共4页China Practical Medicine

摘　　要：目的 探讨腹腔镜下子宫腹直肌悬吊固定术治疗子宫脱垂的临床疗效。方法 75例子宫脱垂患者,随机分为对照组(39例)和观察组(36例)。对照组使用阴式子宫切除术治疗,观察组使用腹腔镜下腹直肌子宫悬吊术治疗。比较两组各项手术指标[手术时间、术中出血量、住院时间及手术前后女性性功能指数调查量表(FSFI)总分],并发症发生情况,手术前后盆腔器官脱垂定量分度法(POP-Q)分度,术前及术后1个月生活质量指标[盆底障碍影响简易问卷7(PFIQ-7)、盆底障碍功能调查表(PFDI-20)、盆腔脏器脱垂/尿失禁性功能问卷(PISQ-12)评分]。结果 两组术前FSFI总分比较差异无统计学意义(P>0.05);观察组手术时间(56.57±11.49)min、住院时间(4.65±0.67)d均短于对照组的(96.72±16.46)min、(6.87±0.79)d,术中出血量(5.64±1.25)ml少于对照组的(50.43±7.26)ml,术后FSFI总分(32.56±1.68)分明显高于对照组的(28.73±2.02)分,差异具有统计学意义(P<0.05)。两组患者的并发症发生率比较差异无统计学意义(P>0.05)。术前,两组患者的POP-Q分度比较差异无统计学意义(P>0.05);术后,观察组POP-Q分度0度的占比明显高于对照组,Ⅰ~Ⅱ度的占比低于对照组,差异具有统计学意义(P<0.05);两组术后均无Ⅲ、Ⅳ度病例。术前,两组患者的PFDI-20、PFIQ-7、PISQ-12评分比较差异均无统计学意义(P>0.05);术后1个月观察组的PFDI-20评分(4.32±1.33)分、PFIQ-7评分(5.24±1.62)分均明显低于对照组的(11.46±2.75)、(13.41±3.19)分, PISQ-12评分(55.83±5.42)分明显高于对照组的(40.67±6.86)分,差异具有统计学意义(P<0.05)。结论 腹腔镜下子宫腹直肌悬吊固定术治疗子宫脱垂的临床疗效显著,与传统子宫切除术对比,能保留子宫完整性,且操作简单,手术操作难度低,创伤小,出血少,有效缩短手术时间,恢复快,并发症少,恢复盆腔正常的解剖结构和脏器功能,维持满意的性功能,提高生活质�Objective To discuss the clinical efficacy of laparoscopic uterine rectus abdominis suspension in the treatment of uterine prolapse.Methods A total of 75 patients with uterine prolapse were randomly divided into control group(39 cases)and observation group(36 cases).The control group was treated with vaginal hysterectomy,and the observation group was treated with laparoscopic uterine rectus abdominis suspension.Both groups were compared in terms of surgical indicators[operation time,intraoperative blood loss,hospitalization time and female sexual function index(FSFI)total score before and after surgery],occurrence of complications,pelvic organ prolapse quantitative scale(POP-Q)staging before and after surgery,quality of life indicators[pelvic floor impact questionnaire-short form 7(PFIQ-7)score,pelvic floor distress inventory-short form 20(PFDI-20)score,pelvic organ prolapse/urinary incontinence sexual questionnaire(PISQ-12)score]before surgery and 1 month after surgery.Results Before surgery,there was no statistically significant difference in the FSFI total score between the two groups(P>0.05).The operation time(56.57±11.49)min and hospitalization time(4.65±0.67)d in the observation group were shorter than(96.72±16.46)min and(6.87±0.79)d in the control group,the intraoperative blood loss(5.64±1.25)ml was less than(50.43±7.26)ml in the control group,and the postoperative FSFI total score(32.56±1.68)points was significantly higher than(28.73±2.02)pointsin the control group.All the differences were statistically significant(P<0.05).There was no statistically significant difference in the complication rate between the two groups(P>0.05).Before surgery,there was no statistically significant difference in the POP-Q score grading between the two groups(P>0.05).After surgery,the proportion of POP-Q grade 0 in the observation group was significantly higher than that in the control group,and the proportion of gradeⅠ-Ⅱwas lower than that in the control group.All the differences were statistically significant(P

关 键 词：子宫脱垂 腹腔镜下子宫腹直肌悬吊固定术 临床疗效 

分 类 号：R713.4[医药卫生—妇产科学]