不同方法治疗子宫脱垂患者的疗效评价  

Evaluation of the Curative Effect of Different Methods in the Treatment of Uterine Prolapse

作　　者：黄思玲 桑琳[1] HUANG Si-ling;SANG Lin(Department of Obstetrics and Gynecology,Hefei Second People’s Hospital,Hefei,Anhui,230000,China)

机构地区：[1]合肥市第二人民医院妇产科,安徽合肥230000

出　　处：《黑龙江医学》2022年第11期1315-1317,共3页Heilongjiang Medical Journal

摘　　要：目的:评价不同方法治疗子宫脱垂患者的临床效果。方法:回顾性分析2018年1月—2020年12月合肥市第二人民医院60例因子宫脱垂住院手术治疗的患者,采用随机原则分为三组,阴式全子宫切除+阴道壁修补术为手术组30例,阴式全子宫切除和/或经阴道经闭孔尿道中段无张力悬吊术(TVT-O)为TVT-O组20例,腹腔镜下髂耻韧带悬吊术为悬吊组10例。比较分析各组患者在手术时间、出血量、住院天数、住院总费用、术后并发症如排尿异常、泌尿系损伤、阴道出血、盆腔血肿情况。结果:悬吊组手术时间、出血量、住院天数低于手术组和TVT-O组,差异有统计学意义(P<0.05),但住院总费用比较,差异无统计学意义(P>0.05)。而手术组与TVT-O组手术时间、出血量和住院总费用比较,差异有统计学意义(P<0.05)。悬吊组术后无明显并发症,手术组出现6例阴道出血,6例排尿异常,TVT-O组出现排尿异常2例,阴道出血4例,均无泌尿系损伤及盆腔血肿发生。结论:三种治疗子宫脱垂患者的手术方法临床效果确切,但腹腔镜下髂耻韧带悬吊术则更具有优势。伴有尿失禁症状,阴式全子宫切除和/或TVT-O能够有效改善患者临床症状,均有重要的临床推广应用价值。Objective:To evaluate the clinical effect of different methods in the treatment of uterine prolapse patients.Methods:A retrospective analysis of 60 patients with uterine prolapse treated in hospital from January 2018 to December 2020 was conducted,and they were randomly divided into three groups.Thirty patients who underwent vaginal hysterectomy+vaginal wall repair were included in the surgery group,and 20 patients who underwent vaginal hysterectomy and/or TVT-O(transvaginal transobturator midurethral tension-free suspension operation)were included in the TVT-O group,10 patients with laparoscopic ilio⁃pubic ligament suspension were selected as the suspension group.The operation time,blood loss,length of hospital stay,total hospi⁃tal cost,postoperative complications such as abnormal urination,urinary tract injury,vaginal bleeding,and pelvic hematoma were compared and analyzed in each group.Results:There were statistically significant differences in operation time,blood loss and hos⁃pital stay in the suspension group in the pairwise comparison of each group(P<0.05).However,there was no statistically signifi⁃cant difference in the total cost of hospitalization(P>0.05).There were statistically significant differences between the operation group and the TVT-O group in terms of operation time,blood loss and total hospitalization costs(P<0.05).There were no obvious postoperative complications in the suspension group.There were 6 cases of vaginal bleeding and 6 cases of abnormal urination in the operation group,2 cases of abnormal urination and 4 cases of vaginal bleeding in the TVT-O group.No urinary tract injury and pelvic hematoma occurred.Conclusion:The clinical effect of the three surgical methods for the treatment of patients with uterine prolapse is exact,but the laparoscopic iliopubic ligament suspension is more advantageous.With urinary incontinence symptoms,vaginal hysterectomy and/or TVT-O can effectively improve the clinical symptoms of patients,and both have important clinical ap⁃plication value.

关 键 词：阴式全子宫切除术 阴道壁修补术 腹腔镜下髂耻韧带悬吊术 经阴道经闭孔尿道中段无张力悬吊术 

分 类 号：R711.23[医药卫生—妇产科学]