腹腔镜辅助阴式子宫切除术联合双侧髂耻韧带悬吊术治疗老年子宫脱垂患者的临床效果分析  

Clinical effects analysis of laparoscopic-assisted vaginal hysterectomy combined with bilateral iliopubic ligament suspension in the treatment of elderly patients with uterine prolapse

作　　者：汪燕[1] 汪凤华 李秀娟 何秀丽 周玲玲[1] 尹宝枝 陈声琴 王芳[1] WANG Yan;WANG Fenghua;LI Xiujuan;HE Xiuli;ZHOU Lingling;YIN Baozhi;CHEN Shengqin;WANG Fang(Department of Obstetrics and Gynecology,Anqing First People's Hospital of Anhui Medical University,Anqing 246000,Anhui,China)

机构地区：[1]安徽医科大学附属安庆第一人民医院妇产科,安徽安庆246000

出　　处：《中国性科学》2024年第1期115-119,共5页Chinese Journal of Human Sexuality

摘　　要：目的分析腹腔镜辅助阴式子宫切除术联合双侧髂耻韧带悬吊术治疗老年子宫脱垂患者的临床效果。方法选取2020年9月至2022年9月安徽医科大学附属安庆第一人民医院治疗的76例老年子宫脱垂患者作为研究对象,采用随机数字表法分为观察组和对照组,各38例。分别采用腹腔镜辅助阴式子宫切除术联合阴道前后壁修补术、腹腔镜辅助阴式子宫切除术联合双侧髂耻韧带悬吊术治疗。比较两组围手术期指标、手术疗效、手术前后盆腔器官脱垂定量分期法(POP-Q)各指示点位置、性功能及阴道穹隆脱垂情况。结果观察组手术时间、术中出血量、术后肛门排气时间、留置导尿管时间均短于或少于对照组(P<0.05);观察组治疗总有效率高于对照组(P<0.05);两组术后3个月POP-Q各指示点位置及女性性功能量表(FSFI)评分均较术前改善(P<0.05),且观察组优于对照组(P<0.05);观察组术后6个月内阴道穹隆脱垂发生率低于对照组(P<0.05)。结论腹腔镜辅助阴式子宫切除术联合双侧髂耻韧带悬吊术治疗老年子宫脱垂疗效确切,创伤小,术后恢复快。Objective To analyze the clinical effects of laparoscopic-assisted vaginal hysterectomy and bilateral iliopubic ligament suspension in the treatment of elderly patients with uterine prolapse.Methods A total of 76 elderly patients with uterine prolapse in Anqing First People's Hospital of Anhui Medical University were enrolled as the research subjects and were divided into observation group and control group by means of the random number table method,with 38 cases in each group.They were given laparoscopic-assisted vaginal hysterectomy combined with anterior and posterior vaginal wall repair,and laparoscopic-assisted vaginal hysterectomy combined with bilateral iliopubic ligament suspension respectively.The perioperative indicators,surgical efficacy,indicator points positions of pelvic organ prolapse quantitative staging(POP-Q),sexual function and vaginal vault prolapse condition before and after surgery were compared between the two groups.Results The surgical time,intraoperative blood loss,postoperative anal exhaust time and urinary indwelling catheter time in observation group were shorter or less than those in control group(P<0.05).The total effective rate of treatment in observation group was higher compared with that in control group(P<0.05).The indication points positions of POP-Q and female sexual function index(FSFI)scores of the two groups were improved at 3 months after surgery compared with those before surgery(P<0.05),and the above indicators in observation group were better than in control group(P<0.05).The incidence rate of vaginal vault prolapse in observation group within 6 months after surgery was lower than that in control group(P<0.05).Conclusions Laparoscopic-assisted vaginal hysterectomy combined with bilateral iliopubic ligament suspension has an exact efficacy,small trauma and fast postoperative recovery in the treatment of elderly patients with uterine prolapse.

关 键 词：腹腔镜 阴式子宫切除术 双侧髂耻韧带悬吊术 老年 子宫脱垂 

分 类 号：R711[医药卫生—妇产科学]