腹腔镜下阴道骶骨固定术治疗中重度子宫脱垂对患者盆底功能恢复及生活质量影响  

Impacts of laparoscopic sacral bone pexis for treating patients with moderate and severe uterine prolapse on their pelvic floor function and quality of life

作　　者：王玉梅 汪香梅 王艳 WANG Yumei;WANG Xiangmei;WANG Yan(Lujiang County People's Hospital,Hefei,Anhui Province,231500)

机构地区：[1]安徽省庐江县人民医院,231500

出　　处：《中国计划生育学杂志》2023年第9期2054-2058,共5页Chinese Journal of Family Planning

摘　　要：目的:分析腹腔镜下阴道骶骨固定术治疗对中重度子宫脱垂效果及对患者盆底功能及生活质量的影响。方法:回顾性收集2018年8月-2022年6月本院确诊的中重度中老年子宫脱垂患者120例,根据治疗方法不同分为腹腔镜下阴道骶骨固定术治疗60例为腹腔镜组、经阴道骶棘韧带悬吊术治疗60例为手术组。比较两组手术相关指标,以及手术前后盆腔器官脱垂(POP-Q)分度法各指示点测量值、生活质量评分,术后并发症。结果:腹腔镜组手术时间、排气时间、术后住院天数、术中出血量均少于手术组;术后6个月,两组阴道前壁、阴道顶端、会阴体长度、阴道后壁均较术前延长,生殖道裂孔长度、阴道总长度(TVL)较术前缩短,且腹腔镜组TVL短于对照组;术后6个月,两组盆底功能障碍性疾病症状问卷(PFDI-20)、盆底障碍影响简易问卷(PFIQ-7)评分均较术前降低,女性性功能指数调查量表(FSFI)评分较术前增高,且腹腔镜组上述指标(11.32±3.16分、12.86±5.14分、26.25±4.49分)均优于手术组(16.28±3.45分、21.88±7.12分、19.32±4.73分),术后尿潴留、肠梗阻、感染、性交痛等并发症总发生率腹腔镜组(8.3%)低于手术组(26.7%)(均P<0.05)。结论:腹腔镜下阴道骶骨固定术能更有效恢复中重度子宫脱垂女性的盆底功能,改善患者生活质量,减少术后并发症。Objective:To analyze the impacts of laparoscopic sacral bone pexis for treating patients with moderate and severe uterine prolapse on their pelvic floor function and quality of life.Methods:120elderly patients with moderate and severe uterine prolapse from August 2018to June 2022were collected in this study retrospectively.According to the different treatments,these patients were divided into two groups.60patients in group A were given laparoscopic sacral bone pexis,and 60patients in group B were given transvaginal sacrospinous ligament suspension.The values of indexes related to operation,the values of each indicator point by pelvic organ prolapse quantification(POP-Q),the score of quality of life before and after operation,and the occurrence of postoperative complications of the patients were compared between the two groups.Results:The operative time,the exhaust time,the postoperative hospitalization days,and the intraoperative blood loss of the patients in group A were all significantly less than those of the patients in group B.In the 6th month after operation,the anterior vaginal wall,the vaginal apex,the perineal body length,and the posterior vaginal wall of the patients in both groups were significantly longer than those before operation,the length of genital tract hiatus and total vaginal length(TVL)of the patients in both groups were significantly shorter than those before operation,and the TVL of the patients in group A was significantly shorter than that of the patients in group B.In the 6th month after operation,the scores of pelvic floor distress inventory(PFDI-20)and pelvic floor disorders influence questionnaire(PFIQ-7)of the patients in both groups were significantly lower than those before operation,and the score of female sexual function index scale(FSFI)of the patients in both groups was significantly higher than that before operation,and all of which(11.32±3.16points,12.86±5.14points,and 26.25±4.49points)of the patients in group A were significantly better than those(16.28±3.45points,21.88

关 键 词：子宫脱垂 腹腔镜下阴道骶骨固定术 经阴道骶棘韧带悬吊术 盆底功能 生活质量 

分 类 号：R713.4[医药卫生—妇产科学]