腹腔镜高位骶韧带悬吊联合传统术式治疗育龄女性盆腔器官脱垂17例分析  

Laparoscopic High Uterosacral Ligament Suspension Combined With Traditional Operation for Pelvic Organ Prolapse in Childbearing Age Women

作　　者：严维高 姜涛 王文吉 Yan Weigao;Jiang Tao;Wang Wenji(Department of Gynecology,Taizhou Maternity Hospital of Nantong University,Taizhou 225300,China)

机构地区：[1]南通大学附属泰州妇产医院妇科,泰州225300

出　　处：《中国微创外科杂志》2022年第9期743-747,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：泰州市科技支撑计划项目(TS201810)。

摘　　要：目的探讨腹腔镜高位骶韧带悬吊(high uterosacral ligament suspension,HUS)联合传统术式(宫颈部分切除、阴道壁修补、会阴修补等)治疗育龄女性盆腔器官脱垂(pelvic organ prolapse,POP)的效果及安全性。方法回顾性分析2016年5月~2021年5月育龄POP患者17例的临床资料,行腹腔镜HUS同时行宫颈部分切除15例,阴道前壁修补12例,阴道后壁修补4例,会阴修补14例。结果17例手术时间(95.8±15.7)min,出血量20~50 ml,住院时间6~8 d。17例随访6~69个月,(39.3±20.6)月。客观成功率94%(16/17),主观成功率100%(17/17)。PGI-I评分非常好13例,很好3例,有些好1例。性生活明显改善13例,改善3例,无变化1例。术后妊娠2例,其中1例已剖宫产分娩。结论腹腔镜HUS联合有效的传统术式治疗有手术指征的育龄女性POP安全,微创,规避植入材料的使用,术式简单易掌握,常规器械即可完成。Objective To explore the effect and safety of laparoscopic high uterosacral ligament suspension(HUS)combined with traditional surgery(partial cervical resection,vaginal wall repair,and perineum repair,etc.)in the treatment of pelvic organ prolapse(POP)in childbearing age women.Methods Clinical data of 17 POP patients at childbearing age from May 2016 to May 2021 were retrospectively analyzed.Laparoscopic HUS was performed,conbined with partial cervical resection in 15 cases,anterior vaginal wall repair in 12 cases,posterior vaginal wall repair in 4 cases,and perineum repair in 14 cases.Results Of the 17 cases,the operation time was(95.8±15.7)min,the blood loss was 20-50 ml,and the hospital stay was 6-8 d.All the 17 cases were followed up for 6-69 months(mean,39.3±20.6 months).The objective success rate was 94%(16/17)and the subjective success rate was 100%(17/17).The PGI-I score was very good in 13 cases,good in 3 cases and some good in 1 case.Sexual life was obviously improved in 13 cases,improved in 3 cases and unchanged in 1 case.There were 2 cases of pregnancy after operation,one of which had been delivered by cesarean section.Conclusions Laparoscopic HUS combined with effective traditional surgery is safe and minimally invasive in the treatment of POP in childbearing age women with surgical indications.Avoiding the use of implant materials,the operation is simple and easy to perform,which can be completed with conventional instruments.

关 键 词：盆腔器官脱垂 育龄女性 联合术式 

分 类 号：R713[医药卫生—妇产科学]