骶主韧带复合体与耻骨阴道肌交叉缝合术治疗中重度子宫脱垂的效果及安全性  

Effect and safety of cross suture of sacral main ligament complex and pubovaginal muscle in the treatment of moderate and severe uterine prolapse

作　　者：孙小霞 思美丽 SUN Xiaoxia;SI Meili(Gynecology Department,Yulin No.2 Hospital,Yulin 719000,China)

机构地区：[1]榆林市第二医院妇科,陕西榆林719000

出　　处：《临床医学研究与实践》2022年第36期82-85,共4页Clinical Research and Practice

基　　金：榆林市科技计划项目(No.YF-2021-62)。

摘　　要：目的探讨骶主韧带复合体与耻骨阴道肌交叉缝合术治疗中重度子宫脱垂的效果及安全性。方法选取我院收治的62例中重度子宫脱垂患者作为研究对象,根据手术方式的不同将其分为观察组(31例,阴式子宫全切术+骶主韧带复合体与耻骨阴道肌交叉缝合术)和对照组(31例,阴式子宫全切术+传统阴道壁修补术)。比较两组的手术相关指标、并发症发生情况、盆腔器官脱垂定量(POP-Q)分度测量值、主观疗效、心理健康状态、满意度及复发情况。结果两组的手术时间、术中出血量及并发症总发生率比较,差异无统计学意义(P>0.05)。术后3个月,两组阴道前壁中线距处女膜3 cm处(Aa)、阴道前穹隆的反褶到Aa点最远处(Ba)、宫颈外口最远处(C)、阴道后壁中线距处女膜缘3 cm处(Ap)、阴道后穹窿的反褶到Ap点最远处(Bp)的POP-Q分度测量值均减小,且观察组明显小于对照组(P<0.05)。术后3个月,两组的盆底障碍影响简易问卷-7(PFIQ-7)、盆底功能障碍简易问卷-20(PFDI-20)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)及症状自评量表(SCL-90)评分均降低,且观察组明显低于对照组(P<0.05)。观察组的满意度高于对照组,总复发率低于对照组(P<0.05)。结论骶主韧带复合体与耻骨阴道肌交叉缝合术治疗中重度子宫脱垂的效果显著,可有效改善患者的临床症状,提高心理健康程度及满意度,并降低复发率。Objective To investigate the effect and safety of cross suture of sacral main ligament complex and pubovaginal muscle in the treatment of moderate and severe uterine prolapse.Methods A total of 62 patients with moderate and severe uterine prolapse admitted in our hospital were selected as the research objects.According to different surgical methods,the patients were divided into observation group(31 cases,total vaginal hysterectomy+cross suture of sacral main ligament complex and pubovaginal muscle)and control group(31 cases,total vaginal hysterectomy+traditional vaginal wall repair).The operation related indexes,complications,Pelvic Organ Prolapse Quantification(POP-Q)index measurement value,subjective efficacy,mental health status,satisfaction and recurrence were compared between the two groups.Results There were no significant differences in operation time,intraoperative bleeding and total incidence of complications between the two groups(P>0.05).Three months after operation,the POP-Q index measurement value at the 3 cm from the midline of the anterior vaginal wall to the hymen(Aa),the farthest point from the anterior vaginal dome to the Aa point(Ba),the farthest point from the outer mouth of the cervix(C),the 3 cm from the midline of the posterior vaginal wall to the hymen edge(Ap),and the farthest point from the posterior vaginal dome to the Ap point(Bp)in both groups reduced,and those in the observation group were significantly smaller than the control group(P<0.05).Three months after operation,the scores of the Pelvic Floor Impact Questionnaire-7(PFIQ-7),the Pelvic Floor Distress Inventory-20(PFDI-20),the Hamilton Anxiety Scale(HAMA),the Hamilton Depression Scale(HAMD)and the Symptom Check List-90(SCL-90)in the two groups decreased,and those in the observation group were significantly lower than the control group(P<0.05).The satisfaction in the observation group was higher than that in the control group,and the total recurrence rate was lower than that in the control group(P<0.05).Conclusion Cross suture o

关 键 词：骶主韧带复合体 耻骨阴道肌 交叉缝合术 传统阴道壁修补术 中重度子宫脱垂 

分 类 号：R711.2[医药卫生—妇产科学]