腹腔镜子宫悬吊联合阴道后壁修补治疗子宫脱垂合并肠疝的临床分析  

Clinical analysis of laparoscopic uterine suspension combined with posterior vaginal wall repair for uterine prolapse complicated with intestinal hernia

作　　者：蒋莉莉 盛昕玫 钟松[3] Jiang Lili;Sheng Xinmei;Zhong Song(Department of Obstetrics and Gynecology,Maanshan Maternal and Child Health Hospital,Maanshan 243000,Anhui Province,China;Department of Gynecology,Maanshan Hospital of Traditional Chinese Medicine,Maanshan 243000,Anhui Province,China;Deparbnent of Obstetrics and Gynecology,Central Hospital Maanshan,Maanshan 243000,Anhui Province,China)

机构地区：[1]马鞍山妇幼保健院妇产科,安徽省2430001 [2]马鞍山市中医院妇科,安徽省243000 [3]马鞍山市中心医院妇产科,安徽省243000

出　　处：《中华疝和腹壁外科杂志（电子版）》2022年第3期266-269,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

基　　金：马鞍山市科技局项目(YL-2021-13)。

摘　　要：目的探究采用腹腔镜子宫悬吊联合阴道后壁修补术对子宫脱垂患者并合并肠疝的治疗效果。方法选取2019年7月至2020年4月于马鞍山市中医院治疗子宫脱垂并发肠疝的女性患者68例纳入研究对象。按照治疗方法的不同将患者分为试验组和对照组,每组患者34例。试验组采用腹腔镜子宫悬吊联合阴道后壁修补治疗,对照组采用阴式子宫切除术联合阴道后壁修补治疗,比较2组患者手术一般情况、术后盆底肌功能、手术成功率和术后并发症。结果试验组术中出血量、手术时间、住院时间均低于对照组(P<0.05)。试验组手术成功率为100%(34/34)高于对照组82.35%(28/34)(P<0.05)。治疗后,2组患者盆底功能障碍评分表-20(PFDI-20)、盆底功能障碍影响问卷-7(PFIQ-7)评分均比治疗前降低(P<0.05),且试验组均低于对照组(P<0.05)。治疗后,2组患者生活满意度量表(SWLS)评分均上升,试验组SWLS评分高于对照组(P<0.05);治疗后2组患者焦虑自评量表(SAS)评分均下降,试验组SAS评分低于对照组(P<0.05)。试验组并发症发生率为2.94%(1/34)低于对照组的20.59%(7/34),差异有统计学意义(P<0.05)。结论腹腔镜子宫悬吊联合阴道后壁修补术对子宫脱垂并发肠疝患者的临床效果更好,显著提升了患者盆底肌功能,不良反应少,安全性高。Objective To explore the clinical effect of laparoscopic uterine suspension combined with vaginal posterior wall repair in the treatment of uterine prolapse complicated with intestinal hernia.Methods Sixty-eight female patients who were treated in Central Hospital Maanshan with uterine prolapse complicated with intestinal hernia from July 2019 to April 2020 were included.Patients were divided into experimental and control groups according to treatment methods,with 34 patients in each group.The experimental group was treated with laparoscopic uterine suspension combined with vaginal posterior wall repair,and the control group was treated with vaginal hysterectomy combined with vaginal posterior wall repair.The general surgical conditions,postoperative pelvic floor muscle function,surgical success rate and postoperative complications of the two groups were compared.Results The amount of intraoperative bleeding,operation time and hospital stay in the experimental group were lower than those in the control group(P<0.05).The success rate of surgery was 100%(34/34)in the experimental group,which was higher than 82.35%(28/34)in the control group(P<0.05).After treatment,PFDI-20 and PFIQ-7 scores of the two group were lower than those before treatment(P<0.05),and PFDI-20 and PFIQ-7 scores were lower in the experimental group than those in the control group(P<0.05).After treatment,SWLS scores increased in both groups,SWLS score was higher in the experimental group than that in the control group(P<0.05).SAS scores in both groups decreased after treatment,and SAS scores were lower in the experimental group than that in the control group(P<0.05).The incidence of complications in the study group was 2.94%(1/34),which was lower than 20.59%(7/34)in the control group(P<0.05).Conclusion Laparoscopic uterine suspension combined with vaginal posterior wall repair has a better effect in patients with uterine prolapse complicated with intestinal hernia,which significantly improved the pelvic floor muscle function,with few adverse reac

关 键 词：子宫脱垂 肠疝 腹腔镜子宫悬吊术 阴道后壁修补术 

分 类 号：R47[医药卫生—护理学]