经阴道自体组织前壁修补联合腹腔镜髂耻韧带悬吊术在治疗前中盆腔器官脱垂中的疗效分析  

Analysis of Clinical Effect of Transvaginal Native Tissue Repair Combined with Laparoscopic Pectopexy in the Treatment of Anterior and Middle Pelvic Organ Prolapse

作　　者：周平平 王燕[1] 韩璐 沈珂[1] 冯丹[3] 严新彦 蔡文强 蒲巍林[1] ZHOU Pingping;WANG Yan;HAN Lu(Department of Urology,Gansu Provincial Maternity and Child Care Hospital(Gansu Provincial Central Hospital),Lanzhou Gansu 730050,China;Department of Propaganda,Gansu Provincial Maternity and Child Care Hospital(Gansu Provincial Central Hospital),Lanzhou Gansu 730050,China)

机构地区：[1]甘肃省妇幼保健院(甘肃省中心医院)生殖泌尿科,甘肃兰州730050 [2]甘肃省妇幼保健院(甘肃省中心医院)宣传统战部,甘肃兰州730050 [3]甘肃省妇幼保健院(甘肃省中心医院)整形和乳腺二科,甘肃兰州730050

出　　处：《实用妇产科杂志》2023年第7期524-527,共4页Journal of Practical Obstetrics and Gynecology

基　　金：甘肃省科技厅重点研发计划(编号:21YF5FA026)。

摘　　要：目的:分析经阴道自体组织前壁修补联合腹腔镜髂耻韧带悬吊术治疗前、中盆腔器官脱垂的疗效。方法:选取2018年1月至2020年12月在甘肃省妇幼保健院生殖泌尿科因盆腔器官脱垂行阴道自体组织前壁修补联合腹腔镜髂耻韧带悬吊手术并完成随访的165例患者。分析其术中情况和术后并发症,并采用盆腔器官脱垂定量分期法(POP-Q),盆底功能障碍性疾病症状问卷(PFDI-20)及其分量表盆腔器官脱垂困扰量表(POPDI-6)、结直肠肛门困扰量表(CRADI-8)和排尿困扰量表(UDI-6),盆底疾病生活质量影响问卷短表(PFIQ-7),盆腔器官脱垂/尿失禁性生活问卷(PISQ-12)对患者术前、术后治疗效果和生活质量进行评价比较。结果:165例患者平均随访时间20.50±2.12月,客观治愈率96.36%,术后与术前比较POP-Q的各指示点明显改善(P<0.05);患者术后PFDI-20、UDI-6、CRADI-8、POPDI-6和PFIQ-7量表评分均较术前明显降低,差异有统计学意义(P<0.05)。有性生活患者术后与术前的PISQ-12评分差异无统计学意义(P>0.05)。围术期并发症共13例,发生率为7.88%,均经保守治疗后痊愈。结论:经阴道自体组织前壁修补联合腹腔镜髂耻韧带悬吊术治疗前、中盆腔脱垂,围术期并发症少,可明显改善患者脱垂症状,提高患者生活质量,是一种有效的联合手术方案。Objective:To analyze the effect of transvaginal native tissue repair combined with laparoscopic pectopexy in the treatment of anterior and middle pelvic organ prolapse.Methods:A retrospective analysis was performed for 165 patients who underwent anterior vaginal wall repair combined with laparoscopic pectopexy due to pelvic organ prolapse in the Department of Urology of Gansu Provincial Maternity and Child Care Hospital from January 2018 to December 2020.The intraoperative conditions and postoperative complications were recorded and analyzed.POP quantitative staging(POP-Q)scores were used.Preoperative and postoperative quality of life and therapeutic effect were evaluated using the pelvic floor distress inventory short form-20(PFDI-20)[including urinary distress inventory-6(UDI-6),colorectal-anal distress inventory-8(CRADI-8),pelvic organ prolapse distress inventory-6(POPDI-6)]and pelvic floor impact questionnaire-7(PFIQ-7)and prolapse and Incontinence sexual function questionnaire short form(PISQ-12).Results:The average follow-up time of 165 patients was 20.50±2.12 months,with an objective cure rate of 96.36%.The indicator points of POP-Q were significantly improved after surgery compared to before surgery(P<0.05).The postoperative scores of PFDI-20,UDI-6,CRADI-8,POPDI-6 and PFIQ-7 were significantly lower than those before surgery,with statistically significant differences(P<0.05).There was no significant difference in PISQ-12 scores between postoperative and preoperative patients with sexual activity(P>0.05).There were 13 cases of perioperative complications,with an incidence of 7.88%,all of which were cured after conservative treatment.Conclusions:Transvaginal native tissue repair combined with laparoscopic pectopexy is an effective combined surgical approach for the treatment of anterior and middle pelvic organ prolapse with minimal perioperative complications and can significantly improve the symptoms of prolapse and improve the quality of life.

关 键 词：前中盆腔器官脱垂 自体组织修补 髂耻韧带悬吊术 疗效 

分 类 号：R713[医药卫生—妇产科学]