骶棘韧带固定术联合经阴道子宫切除和阴道壁修补术治疗子宫脱垂的效果  

Sacrospinous ligament fixation combined with transvaginal hysterectomy and vaginal wall repair in the treatment of uterine prolapse

作　　者：程丽娟 李荣[1] CHENG Lijuan;LI Rong(Department of Gynecology and Obstetrics,Chizhou People’s Hospital,Chizhou Anhui 247000,China)

机构地区：[1]池州市人民医院妇产科,安徽池州247000

出　　处：《临床与病理杂志》2023年第2期344-351,共8页Journal of Clinical and Pathological Research

摘　　要：目的:探讨骶棘韧带固定术(sacrospinous ligament fixation,SSLF)联合经阴道子宫切除术和阴道壁修补术治疗子宫脱垂的疗效及对并发症、性生活质量和复发的影响。方法:回顾性分析2019年1月至2022年2月池州市人民医院收治的104例子宫脱垂患者的临床资料。根据不同的手术方式分为对照组(n=60)与观察组(n=44)。对照组实施经阴道子宫切除术+阴道壁修补术治疗;观察组实施SSLF+经阴道子宫切除术+阴道壁修补术治疗。2组均在术后6个月行门诊复查和随访。比较2组围手术期相关指标、治疗效果[盆腔脏器脱垂定量检查(Pelvic Organ Prolapsed Quantitation,POP-Q)分度各指标测量结果、主观满意度和复发率],并比较2组术前及术后6个月性生活质量[盆腔器官脱垂/尿失禁性生活质量调查量表(Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire 12,PISQ-12)]、生活质量[盆腔功能障碍影响问卷(Pelvic Floor Distress Inventory 20,PFDI-20)及盆腔疾病生活质量影响问卷简表(Pelvic Floor Impact Questionnaire 7,PFIQ-7)]及随访期间并发症情况。结果:2组术后6个月POP-Q分度各指标测量结果较术前改善明显(均P<0.05),但组间差异无统计学意义(P>0.05)。术后6个月,观察组PISQ-12量表总分及各维度评分均高于对照组(均P<0.05)。观察组主观满意度为97.73%,高于对照组的86.67%(P<0.05)。2组并发症发生率差异无统计学意义(P>0.05)。观察组PFDI-20及PFIQ-7量表评分均低于对照组(均P<0.05)。结论:SSLF+经阴道子宫切除术+阴道壁修补术治疗子宫脱垂的疗效好,患者主观满意度高,能显著提高患者术后性生活质量和生活质量,术后并发症少。Objective:To investigate the effect of sacrospinous ligament fixation(SSLF)combined with transvaginal hysterectomy and vaginal wall repair in the treatment of uterine prolapse and its effect on complications,quality of sexual life and recurrence.Methods:The clinical data of 104 patients with uterine prolapse admitted to Chizhou People’s Hospital from January 2019 to February 2022 were retrospectively analyzed.According to the different surgical methods,they were divided into a control group(n=60)and an observation group(n=44).The control group was treated with transvaginal hysterectomy+vaginal wall repair;the observation group received SSLF+transvaginal hysterectomy+vaginal wall repair treatment.Outpatient review and follow-up were performed 6 months after the operation in both groups.The perioperative related indicators,treatment effects[Pelvic Organ Prolapsed Quantitation(POP-Q)score measurement results,subjective satisfaction,and recurrence rate]were compared between the 2 groups,and the quality of sexual life[Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire 12(PISQ-12)],quality of life[Pelvic Floor Distress Inventory 20(PFDI-20)and Pelvic Floor Impact Questionnaire 7(PFIQ-7)]before and after 6 months and complications during follow-up were compared between the 2 groups.Results:The POP-Q scores of the 2 groups were significantly improved at the 6th month after the operation(all P<0.05),but there was no significant difference between the 2 groups(P>0.05).At the 6th month after the operation,the total score and each dimension score of PISQ-12 scale in the observation group were higher than those in the control group(all P<0.05).The subjective satisfaction of the observation group was 97.73%,which was higher than 86.67%of the control group(P<0.05).There was no significant difference in the incidence of complications between the 2 groups(P>0.05).The scores of PFDI-20 and PFIQ-7 in the observation group were lower than those in the control group(all P<0.05).Conclusion:SSLF+transvaginal hysterectomy

关 键 词：子宫脱垂 骶棘韧带固定术 子宫切除术 阴道修补术 疗效 

分 类 号：R713[医药卫生—妇产科学]