腹腔镜下治疗老年Ⅲ度子宫脱垂合并阴道前后壁膨出的效果观察  

Observation of the Effect of Laparoscopy in the Treatment of Elderly Patients with Grade Ⅲ Uterine Prolapse Complicated with Vaginal Anterior and Posterior Wall Bulge

作　　者：李影 郑宇 Li Ying;Zheng Yu(The First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000 China)

机构地区：[1]锦州医科大学附属第一医院,辽宁锦州121000

出　　处：《锦州医科大学学报》2022年第4期53-56,共4页Journal of Jinzhou Medical University

基　　金：辽宁教育厅科学研究项目,项目编号:LJKZ0810。

摘　　要：目的研究老年Ⅲ度子宫脱垂合并阴道前后壁膨出患者在腹腔镜下行子宫悬吊联合阴道前后壁修补术的临床效果。方法选取2020年1月至2021年1月在本院100例老年Ⅲ度子宫脱垂合并阴道前后壁膨出的患者,依据手术方式不同将患者分为两组,各50例,研究组采取腹腔镜下子宫悬吊+阴道前后壁修补术,参照组开展阴式子宫切除术(transvaginal hysterectomy,TVH)+阴道前后壁修补术,对比两组治疗后临床效果,观察两组并发症发生率,同时对比两组术中失血量、术后排气时间以及住院天数,并观察两组术后不同时间段数字疼痛评分量表(NRS)评分,使用生活质量调查表(SF-36)评估两组生活质量。结果对比参照组,研究组总有效率较高,并发症发生率较低(P<0.05);相较于参照组,研究组术中失血量较少,术后排气时间与住院天数均较短(P<0.05);与参照组相比,研究组术后1 d、3 d、5 d NRS评分均较低(P<0.05);术前两组一般健康状况、生理功能、精神健康、社会功能对比无差异(P>0.05),术后与参照组相比,研究组评分均高(P<0.05)。结论对老年Ⅲ度子宫脱垂合并阴道前后壁膨出的患者开展腹腔镜下子宫悬吊+阴道前后壁修补术,能够促进术后排气时间,加快患者康复速度,且术后患者疼痛程度轻,并发症发生率低,安全性高,加快患者出院速度,提升其生活质量,值得借鉴。Objective To study the clinical effect of laparoscopic uterine suspension complicated with vaginal anterior and posterior wall repair in elderly patients with grade III uterine prolapse combined with vaginal anterior and posterior wall bulging.Methods From January 2020 to January 2021,100 elderly patients with grade Ⅲ uterine prolapse complicated with anterior and posterior vaginal wall bulging were selected in our hospital.According to different surgical methods,the patients were divided into two groups,with 50 cases in each group.Laparoscopic uterine suspension combined with anterior and posterior vaginal wall repair was adopted as the research group.The control group was treated with transvaginal hysterectomy(TVH)combined with vaginal wall repair.The clinical effect after treatment was compared between the two groups,and the incidence of complications between the two groups was observed.Meanwhile,the intraoperative blood loss,postoperative exhaust time and length of hospital stay were compared between the two groups.The Numerical Rating Scale(NRS)score at different postoperative time was observed between the two groups,and the quality-of-life questionnaire(SF-36)was used to evaluate the quality of life of the two groups.Results Compared with the control group,the total effective rate of the study group was higher,but the incidence of complications was lower(P<0.05);compared with the control group,the study group had less intraoperative blood loss,shorter postoperative exhaust time and hospitalization days(P<0.05);compared with the control group,the NRS score of the study group was lower at 1 d,3 d and 5 d after surgery(P<0.05);there were no differences in general health status,physiological function,mental health and social function between the two groups before surgery(P>0.05),and the scores of the study group were higher than that of the reference group after surgery(P<0.05).Conclusion For elderly patients with grade Ⅲ uterine prolapse complicated with vaginal anterior and posterior wall bulging,laparosc

关 键 词：Ⅲ度子宫脱垂 阴道前后壁膨出 腹腔镜下子宫悬吊术 阴式子宫切除术 

分 类 号：R713.4[医药卫生—妇产科学]