改良保留子宫的髂耻韧带悬吊术治疗盆腔脏器脱垂临床效果  

Clinical effect of the modified uterus-preserving iliopelvic ligament suspension for treating patients with pelvic organ prolapsed

作　　者：郁胜胜 袁帅 宋静林 于鹃鹏[1] YU Shengsheng;YUAN Shuai;SONG Jinglin;YU Juanpeng(Huai'an First Hospital,Nanjing Medical University,Huai'an,Jiangsu Province,223300;Langao County Hospital of Traditional Chinese Medicine,Ankang,Shannxi Province)

机构地区：[1]南京医科大学附属淮安一院,223300 [2]陕西省岚皋县中医院

出　　处：《中国计划生育学杂志》2023年第9期2115-2119,2126,共6页Chinese Journal of Family Planning

摘　　要：目的:探讨改良保留子宫的髂耻韧带悬吊术治疗盆腔脏器脱垂临床疗效。方法:选取2020年1月-2022年1月本院收治的72例盆腔脏器脱垂患者,随机分组法分为观察组(采用改良保留子宫的腹腔镜下髂耻韧带悬吊术治疗)36例与对照组(采用腹腔镜下腹壁悬吊术治疗)36例。观察两组围术期指标、盆腔器官脱垂定量(POP-Q)分度情况、生活质量改善情况、疼痛情况、并发症情况和盆底肌力。结果:术中出血量观察组(32.2±6.3ml)低于对照组(40.9±8.5ml),治疗后观察组POP-Q分度0度占比(88.9%)高于对照组(66.7%),治疗后1~6个月期间观察组生活质量评分均低于对照组,术后3h、术后1d、术后2d时观察组疼痛评分均低于对照组,并发症总发生率观察组(2.8%)低于对照组(16.7%),观察组盆底肌力Ⅴ级占比(63.9%)高于对照组(25.0%)(均P<0.05)。结论:改良保留子宫的髂耻韧带悬吊术治疗能够更好改善盆腔器官脱垂患者盆底肌力,提高生活质量。Objective:To investigate the clinical effect of the modified uterus-preserving iliopelvic ligament suspension for treating patients with pelvic organ prolapse.Methods:72patients with pelvic organ prolapse were selected and were randomly divided into observation group(36patients treated with modified uterus-preserving laparoscopic iliopelvic ligament suspension)and control group(36patients treated with laparoscopic abdominal wall suspension)from January 2020to January 2022.The situations of perioperative indexes,the quantitative pelvic organ prolapse(POP-Q)index,the quality of life improvement,the pain,the complications,and the pelvic floor muscle strength of the patients in the two groups were observed.Results:The intraoperative blood loss(32.2±6.3ml)of the patients in the observation group was significantly lower than that(40.9±8.5ml)of the patients in the control group.The proportion of 0grade of the POP-Q scale(88.9%)of the patients in the observation group after treatment was significantly higher than that(66.7%)of the patients in the control group.The quality of life score of the patients in the observation group during 1 to 6months after treatment was significantly lower than that of the patients in the control group.The pain score of the patients in the observation group at 3h,1d,or 2dafter surgery was significantly lower than that of the patients in the control group.The total complication rate(2.8%)of the patients in the observation group was significantly lower than that(16.7%)of the patients in the control group,and the proportion of grade V of pelvic floor muscle strength(63.9%)of the patients in the observation group was significantly higher than that(25.0%)of the patients in the control group(all P<0.05).Conclusion:The modified uterus-preserving iliopelvic ligament suspension for treating patients with pelvic organ prolapsed can better improve their pelvic floor muscle strength and their quality of life.

关 键 词：改良的髂耻韧带悬吊术 盆腔脏器脱垂 骨质疏松性胸腰椎骨折 盆腔器官脱垂定量 

分 类 号：R713[医药卫生—妇产科学]