腹腔镜改良宫骶韧带顶端悬吊术治疗中重度盆腔器官脱垂效果评估  

Evaluation of laparoscopic modified uterosacral ligament top suspension in the treatment of moderate and severe pelvic organ prolapse.

作　　者：李书勤 褚梦龙 郭耀省 丁锦 王梅 邵艳婷 倪观太 LI Shu-qin;CHU Meng-long;GUO Yao-sheng;DING Jin;WANG Mei;SHAO Yan-ting;NI Guan-tai(Department of Gynecology,the First Affiliated Hospital of Wannan Medical College,Wuhu 241001,China)

机构地区：[1]皖南医学院第一附属医院妇科,安徽芜湖241001

出　　处：《中国实用妇科与产科杂志》2023年第3期342-344,共3页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：安徽省科技厅科技攻关项目(201904a7020033)。

摘　　要：目的探讨腹腔镜改良宫骶韧带顶端悬吊术治疗中重度盆腔器官脱垂的有效性。方法选取2019年1月至2021年1月于皖南医学院第一附属医院通过腹腔镜改良宫骶韧带顶端悬吊术治疗中重度盆腔器官脱垂并于术后按时随访的47例患者,记录患者基本资料、围术期相关数据,并进行长达18个月的随访。通过比较盆腔器官脱垂定量(POP-Q)分度的变化评价手术的客观疗效,通过比较盆底功能障碍问卷(PFDI)-20评分的变化评价手术的主观疗效。结果平均手术时间(111.4±20.2)min,平均出血量(50.8±21.6)mL;平均恢复排气时间为术后(33.8±6.8)h;平均术后住院时间(3.75±0.6)d。术中术后无明显并发症。47例患者随访18个月,术后POP-Q分度及PFDI-20评分显示所有患者的客观脱垂程度及盆底生活质量均明显改善,各指示点虽随时间发生不同程度下移,但无复发者。结论腹腔镜改良宫骶韧带顶端悬吊术可有效治疗中重度盆腔器官脱垂,手术安全性高,无须使用网片,值得在临床进行推广。Objective To evaluate the efficacy of laparoscopic modified uterosacral ligament top suspension in the treatment of moderate and severe pelvic organ prolapse.Methods From January 2019 to January 2021,47 patients with moderate and severe pelvic organ prolapse were treated by laparoscopic modified uterosacral ligament top suspension and were followed up on time after operation in the First Affiliated Hospital of Wannan Medical College.The basic data and perioperative data of the patients were recorded and follow-up was performed for up to 18 months.The Objective effect of the operation was evaluated by comparing the changes of pelvic organ prolapse quantification(POP-Q)grading.The subjective effect of the operation was evaluated by comparing the changes of the pelvic floor distress inventory-short form 20(PFDI-20)score.Results The average operation duration was(111.4±20.2)min,and the average bleeding volume was(50.8+21.6)mL.The average time to recover exhaust was(33.8±6.8)hours after operation.The average postoperative hospital stay was(3.75+0.6)days.There were no obvious complications during or after operation.The 47 patients were followed up for 18 months.Postoperative POP-Q grading and PFDI-20 score showed that the objective prolapse degree and pelvic floor quality of life of all patients were significantly improved.Although each indicator point decreased to varying degrees with time,there was no recurrence.Conclusion Laparoscopic modified uterosacral ligament top suspension can effectively treat moderate and severe pelvic organ prolapse with high surgical safety and no mesh,so it is worth popularizing in clinic.

关 键 词：盆腔器官脱垂 宫骶韧带悬吊 疗效 

分 类 号：R711.5[医药卫生—妇产科学]