经阴道自然腔道内镜阴道骶骨固定术治疗中盆腔缺陷短期和中期疗效分析  

Analysis of Short-and Mid-term Therapeutic Effects of Transvaginal Natural Orifice Transluminal Endoscopic Surgery Sacrocolpopexy in the Treatment of Middle Compartment Prolapse

作　　者：陈诗慧 李广清 陈艳[1] 刘启煌 谭理平 刘娟[1] CHEN Shihui;LI Guangqing;CHEN Yan;LIU Juan(Department of Obstetrics and Gynecology,The Third Affiliated Hospital of Guangzhou Medical University,Guangzhou Guangdong 510150,China;Department of Obstetrics and Gynecology,Guangzhou Panyu Central Hospital,Guangzhou Guangdong 511400,China)

机构地区：[1]广州医科大学附属第三医院妇产科,广东广州510150 [2]广州市番禺区中心医院妇产科,广东广州511400

出　　处：《实用妇产科杂志》2022年第7期525-528,共4页Journal of Practical Obstetrics and Gynecology

基　　金：广州市科技计划项目(编号:202102010004)。

摘　　要：目的:探讨经阴道自然腔道内镜(vNOTES)阴道骶骨固定术治疗中盆腔缺陷的短期和中期疗效。方法:收集2017年6月至2021年3月因中盆腔缺陷行vNOTES阴道骶骨固定术68例患者的临床资料进行回顾性分析。记录围手术期相关指标,采用盆腔器官脱垂定量分度法(POP-Q)、盆底功能障碍问卷(PFDI-20)、盆底障碍影响简易问卷7(PFIQ-7)、盆腔器官脱垂术后患者全身状况改善问卷(PGI-I)评估患者治疗效果。结果:68例患者均顺利完成手术,无围手术期并发症。随访时间36.79±12.85个月,所有患者均完成术后6个月随访,其中有48位患者接受至少3年的随访,术后短期及中期随访POP-Q评分及PFDI-20、PFIQ-7评分与术前比较差异有统计学意义(P<0.05),术后36个月与术后6个月的POP-Q评分及PFDI-20、PFIQ-7评分差异无统计学意义(P>0.05)。PGI-I均为“明显改善”,主、客观治愈率为100%。随访期间出现3例网片暴露(4.41%),7例新发尿失禁(10.29%),所有并发症经处理后症状均好转。结论:vNOTES阴道骶骨固定术安全可行,疗效肯定且中期疗效不亚于短期疗效。Objective:To investigate short-term and medium-term efficacy of transvaginal natural orifice transluminal endoscopic surgery(vNOTES)sacrocolpopexy in the treatment of middle compartment prolapse.Methods:The clinical data of 68 patients who underwent vNOTES sacrocolpopexy for middle compartment prolapse from June 2017 to March 2021 were collected and analyzed retrospectively.The relevant indexes during the perioperative period were recorded,and the treatment effect of patients was evaluated by Pelvic Organ Prolapse Quantitation(POP-Q),and the quality of life of the patients was assessed by the Pelvic Floor Distress Inventory(PFDI-20),Pelvic Floor Impact Questionnaire(PFIQ-7)and the Patient Global Impression of Improvement(PGI-I).Results:All 68 patients successfully completed the operation without perioperative complications,The follow-up time was 36.79±12.85 months.All patients were followed up 6 months after surgery,and 48 patients were followed up for at least 3 years.The POP-Q,PFDI-20 and PFIQ-7 scores in the short-term and medium-term follow-up after operation were significantly different from those before surgery(P<0.05).There was no significant difference in POP-Q,PFDI-20,and PFIQ-7 scores between 36 months and 6 months after operation(P>0.05).PGI-I were all“significantly improved”.Subjective and objective cure rate were 100%.During the follow-up period,there were 3 cases of mesh exposure(4.41%),7 cases of new-onset urinary incontinence(10.29%),and symptoms of all complications were improved after treatment.Conclusions:The vNOTES sacrocolpopexyis safe and feasible,and the mid-term curative effect is no less than the short-term curative effect.

关 键 词：盆腔器官脱垂 中盆腔缺陷 经阴道自然腔道内镜手术 阴道骶骨固定术 

分 类 号：R711.2[医药卫生—妇产科学]