腹腔镜下高位骶韧带悬吊术与阴道骶骨固定术治疗中盆腔器官脱垂的疗效分析  

To compare the efficacy of laparoscopic high sacral ligament suspension with vaginal sacral fixation in the treatment of middle pelvic organ prolapse

作　　者：许华瑞 张燕 张洪炜 赵福英 包生武 高智达 丁永慧[3] XU Huarui;ZHANG Yan;ZHANG Hongwei;ZHAO Fuying;BAO Shengwu;GAO Zhida;DING Yonghui(Yinchuan Maternal and Child Health Hospital,Yinchuan 750001,China;Department of Gynecology,Yinchuan Maternal and Child Health Hospital,Yinchuan 750001,China;Department of Gynecology,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏银川市妇幼保健院,宁夏银川750004 [2]宁夏银川市妇幼保健院妇科,宁夏银川750001 [3]宁夏医科大学总医院妇科,宁夏银川750004

出　　处：《宁夏医学杂志》2023年第11期992-995,共4页Ningxia Medical Journal

摘　　要：目的对比分析腹腔镜下高位骶韧带悬吊术与阴道骶骨固定术治疗中盆腔器官脱垂的疗效。方法选取中盆腔器官脱垂患者80例,根据治疗术式不同分为2组,对照组(n=42)采用腹腔镜下子宫全切后行阴道骶骨固定术治疗,观察组(n=38)采用腹腔镜下子宫全切后行高位骶韧带悬吊术治疗。比较2组围术期指标、手术效果、生活质量及并发症发生情况。结果观察组手术时间短于对照组(P<0.05);2组术中出血量、术后留置尿管时间及住院时间比较差异有统计学意义(P>0.05)。观察组治愈率为94.74%、对照组为90.48%;观察组复发率为2.63%、对照组为7.14%;2组客观治愈率、复发率比较差异有统计学意义(P>0.05)。术后6个月、12个月,2组盆底功能障碍问卷(PFDI-20)、盆底障碍影响简易问卷7(PFIQ-7)评分均呈下降趋势,且观察组术后6个月、12个月PFDI-20、PFIQ-7评分低于对照组(P<0.05)。观察组并发症发生率为5.26%,低于对照组的21.43%(P<0.05)。结论腹腔镜下高位骶韧带悬吊术与阴道骶骨固定术治疗中盆腔器官脱垂均具有良好的疗效,但高位骶韧带悬吊术手术时间短,因具有使用自体组织修复、无网片侵蚀暴露等优势,效果较为满意。Objective To compare and analyze the efficacy of laparoscopic high sacral ligament suspension and vaginal sacral fixation in the treatment of middle pelvic organ prolapse.Methods Eighty patients with middle pelvic organ prolapse were selected and divided into two groups according to the treatment procedure.The control group(n=42)was treated by laparoscopic total uterine excision followed by vaginal sacral fixation,and the observation group(n=38)was treated by laparoscopic total uterine excision followed by high sacral ligament suspension.The perioperative indicators,surgical results,quality of life and complications of the two groups were compared.Results The operative time of the observation group was shorter than that of the control group(P<0.05).The intraoperative bleeding,postoperative indwelling urinary catheter time and hospital stay were compared between the two groups(P>0.05).The objective cure rate was(94.74%)in the observation group and(90.48%)in the control group.The recurrence rate was(2.63%)in the observation group and(7.14%)in the control group.The objective cure rate and recurrence rate were compared between the two groups(P>0.05).At 6 months and 12 months after surgery,the scores of pelvic floor dysfunction questionnaire(PFDI-20)and Simple Questionnaire on the Impact of Pelvic Floor Disorders 7(PFIQ-7)were decreased in both groups,and the PFDI-20 and PFIQ-7 scores of the observation group were lower than those of the control group at 6 and 12 months after surgery(P<0.05).The complication rate in the observation group was(5.26%),which was lower than that in the control group(21.43%)(P<0.05).Conclusion Laparoscopic high sacral ligament suspension and vaginal sacral fixation in the treatment of pelvic organ prolapse has a good effect,high sacral ligament suspension has a short operation time,due to the use of autologous tissue repair,no mesh erosion exposure and other advantages,and the effect is satisfactory.

关 键 词：中盆腔器官脱垂 高位骶韧带悬吊 阴道骶骨固定术 疗效对比 

分 类 号：R713[医药卫生—妇产科学]