应用新型盆底穿刺引导器行经阴道高位骶棘韧带固定术的临床疗效及安全性研究  

Clinical effectiveness and safety of transvaginal high sacrospinous ligament suspension with the application of a new pelvic floor puncture guide

作　　者：李明悦 汪萍 程晨晨 黄周[1] 蔡红红 范文 周金华[1] 王娟[1] 丁红梅[1] 陈友国[1] 沈芳荣[1] LI Ming-yue;WANG Ping;CHENG Chen-chen;HUANG Zhou;CAI Hong-hong;FAN Wen;ZHOU Jin-hua;WANG Juan;DING Hong-mei;CHEN You-guo;SHEN Fang-rong(The First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院妇产科,江苏苏州215006

出　　处：《中国实用妇科与产科杂志》2024年第1期114-118,共5页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：江苏省妇幼健康科研项目(F2019017)。

摘　　要：目的探讨使用新型盆底穿刺引导器行经阴道高位骶棘韧带固定术的临床疗效及其安全性。方法回顾性分析2020年4月至2022年11月苏州大学附属第一医院收治的盆腔器官脱垂患者中使用新型盆底穿刺引导器行经阴道高位骶棘韧带固定术的42例患者(研究组),以无盆底功能障碍性疾病的24例女性为正常组。研究组患者术后进行磁共振成像(MRI)扫描检查,测量阴道仰角并与正常组比较;采用盆底功能障碍问卷(PFDI-20)评估术后患者生活质量变化。结果使用新型盆底穿刺引导器行经阴道高位骶棘韧带固定术的患者,术后与正常组比较MRI测量的阴道仰角,差异无统计学意义(P>0.05),斯皮尔曼相关系数检验提示术后阴道仰角与年龄、孕产次、BMI等人口统计学变量无明显相关性。患者术后PFDI-20评分较术前明显降低,差异具有统计学意义(P<0.05)。结论使用行经阴道高位骶棘韧带固定术是具有创新性且便捷、高效、安全的术式,术中可通过使用器械到达高位解剖点,术后能保留正常的阴道轴向,改善患者盆底功能障碍,优化患者生活质量,具有良好的临床效果,是治疗盆腔器官脱垂的有效手术方式。Objective To investigate the clinical efficacy and safety of transvaginal high sacrospinous ligament suspen⁃sion using a new pelvic floor puncture guide for the treatment of pelvic organ prolapse.Methods It is a retrospective study of forty-two patients with pelvic organ prolapse admitted to the First Affiliated Hospital of Soochow University,who underwent transvaginal high sacrospinous ligament suspension using a new pelvic floor puncture guide between April 2020 and November 2022.Postoperative MRI scans were performed,and a normal control group of twenty-four female patients without pelvic floor dysfunction was included for comparative analysis of vaginal elevation angles.Changes in quality of life were evaluated using the Pelvic Floor Dysfunction Questionnaire(PFDI-20).Results MRI scans revealed no significant difference in vaginal elevation angles between postoperative patients and the normal group(P>0.05).Spearman′s correlation test indicated no significant correlation between vaginal elevation angles and demographic vari⁃ables(age,number of pregnancy and delivery,BMI).The PFDI-20 scores of patients after operation were significantly lower than those before the operation(P<0.05).Conclusion Transvaginal high sacrospinous ligament suspension us⁃ing a new pelvic floor puncture guide is an innovative,convenient,efficient,and safe surgical approach,and the use of the instrument allows access to the high anatomical point.It represents an effective treatment option for pelvic organ pro⁃lapse,which preserves the normal vaginal axis,improves pelvic floor dysfunction,optimize quality of life,and demon⁃strates good clinical outcomes.

关 键 词：盆腔器官脱垂 新型盆底穿刺引导器 经阴道高位骶棘韧带固定术 女性盆底解剖 

分 类 号：R711.23[医药卫生—妇产科学]