腹腔镜下保留子宫髂耻韧带固定术与骶骨固定术治疗盆腔脏器脱垂效果比较  

Effect of laparoscopic iliopexic ligament with uterine preservation and sacral fixation for treating pelvic organ prolapse

作　　者：程会芳[1] 权丽丽[1] 汤晓 张玉琼[1] 曲丽霞[1] CHENG Huifang;QUAN Lili;TANG Xiao;ZHANG Yuqiong;QU Lixia(Sanmenxia Central Hospital,Sanmenxtia,Henan Province,472000)

机构地区：[1]河南省三门峡市中心医院,472000

出　　处：《中国计划生育学杂志》2023年第4期858-862,共5页Chinese Journal of Family Planning

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20191440)。

摘　　要：目的:探讨腹腔镜下保留子宫髂耻韧带固定术与骶骨固定术治疗盆腔脏器脱垂的效果。方法:选择2020年1月-2022年12月本院治疗的105例盆腔脏器脱垂患者,随机数表法分为保守组(n=53)和对照组(n=52)。对照组给予骶骨固定术治疗,保守组给予腹腔镜下保留子宫的髂耻韧带固定术治疗。比较两组围术期指标、器官脱垂程度、尿动力学、性功能、盆底疾病生活质量影响问卷简表(PFIQ-7)、盆底功能障碍疾病相关问卷简表(PFDI-20)、盆底器官脱垂对性功能影响调查问卷(PISQ-12)及不良反应。结果:两组术后残余尿量、住院时间比较无差异;保守组手术时间(70.6±17.2 min)及出血量(63.5±12.2ml)低于对照组(92.4±18.5 min、86.0±24.8 ml);两组器官脱垂程度均显著改善且保守组I~II级患者(67.9%)高于对照组(42.3%);两组性功能满意度均升高且保守组(3.91±1.07分)高于对照组(2.73±0.99分);两组PFIQ-7、PFDI-20均降且保守组(22.35±4.21分、13.89±3.44分)低于对照组(28.97±5.19分、17.59±4.64分),PISQ-12均升高且保守组(39.85±4.14分)高于对照组(34.56±3.86分)(均P<0.05);治疗期间,两组不良反应主要为腰骶部疼痛、下坠感、腹部牵拉痛及排便异常,总发生率对照组(21.2%)高于保守组(7.6%)(P<0.05)。结论:治疗盆腔脏器脱垂应用腹腔镜下保留子宫的髂耻韧带固定术与骶骨固定术疗效相当,但前者手术时间更短,出血量更少,性功能恢复更好,不良反应降低。Objective:To study the effect of contrast of laparoscopic iliopexic ligament with uterine preservation and sa-cral fixation for treating pelvic organ prolapse.Methods:105 patients with pelvic organ prolapse were selected and di-vided into experimental group(n=53)and control group(n=52)by random number table method from J anuary 2020 to December 2022.The patients in the control group were treated with sacral fixation,and the patients in the experi-mental group were treated with laparoscopic iliopexic ligament with uterine preservation.The changes of perioperative conditions,the degree of organ prolapse,the urodynamics,the sexual function,the scores of pelvic floor disease quali-ty of life questionnaire(PFIQ-7),pelvic floor dysfunction disease related questionnaire(PFDI-20),and pelvic floor or-gan prolapse on sexual function questionnaire(PISQ-12),and the occurrence of adverse reactions of the patients were compared between the two groups.Results:There were no significant differences in the postoperative residual urine volume and the duration of the hospital stay of the patients between the two groups.The operation time(70.6±17.2.min)and the blood loss(63.5±12.2 ml)of the patients in the experimental group were significantly lower than those(92.4±18.5 min and 86.0±24.8 ml)of the patients in the control group.The degree of organ prolapse of the patients in both groups had increased significantly,and which(67.9%)of the patients in the experimental group was significantly higher than that(42.3%)of the patients in the control group.The satisfaction of sexual function of the patients in both groups had increased significantly,and which(3.91±1.07 points)of the patients in the experimental group was significantly higher than that(2.73±0.99 points)of the patients in the control group.The scores of PFIQ-7 and PFDI-20 of the patients in both groups had decreased significantly,and which(22.35±4.21 points and 13.89±3.44 points)of the patients in the experimental group were significantly higher than those(28.97±5.19 po

关 键 词：盆腔脏器脱垂 腹腔镜下 保留子宫 骶骨固定术 髂耻韧带固定术 效果 

分 类 号：R713[医药卫生—妇产科学]