腹腔镜下骶棘韧带固定联合高位骶韧带悬吊术治疗中盆腔器官脱垂临床分析  

Clinical analysis of laparoscopic sacrospinous ligament fixation combinedwith high sacral ligament suspension in the treatment of middle pelvic organ prolapse

作　　者：杨雅静 周留林 宋文武 王君 印慧琴 杨纪实 YANG Yajing;ZHOU Liulin;SONG Wenwu;WANG Jun;YIN Huiqin;YANG Jishi(Department of Obstetrics and Gynecology,Bengbu Medical University Affiliated Taixing Clinical College,Taixing Jiangsu 225400,China;Department of Traditional Chinese Medicine,Bengbu Medical University Affiliated Taixing Clinical College,Taixing Jiangsu 225400,China)

机构地区：[1]蚌埠医科大学附属泰兴临床学院妇产科,江苏泰兴225400 [2]蚌埠医科大学附属泰兴临床学院中医妇科,江苏泰兴225400

出　　处：《蚌埠医学院学报》2024年第3期331-334,共4页Journal of Bengbu Medical College

基　　金：江苏省卫生健康委科研项目(Z2020072)。

摘　　要：目的:探讨腹腔镜下骶棘韧带固定联合高位宫骶韧带悬吊术治疗中盆腔器官脱垂的可行性、安全性和临床疗效。方法:选择妇产科收治的32例病人(其中子宫脱垂31例和子宫切除术后阴道穹窿脱垂1例)行腹腔镜下骶棘韧带固定术联合骶韧带高位悬吊术,术后第1、3、6、9、12个月定期随访。结果:32例腹腔镜下骶棘韧带固定术联合骶韧带高位悬吊术手术病例全部顺利完成,其中31例行全子宫切除术,4例行阴道后壁修补术,5例行阴道前壁修补术,1例行会阴体修补术,1例行尿道中段折叠术。手术中病人出血50~150 mL,手术时间90~150 min。术后胃肠功能恢复时间1~3 d,保留尿管时间1~3 d,住院时间4~9 d。术后出现臀部疼痛2例,未作特殊处理,疼痛不适感均在手术后3~4 d自然缓解。术后随访时间1~24个月,客观治愈率和主观治愈率全部为100%。结论:对于中盆腔器官脱垂病人,采用腹腔镜下骶棘韧带固定术联合高位骶韧带悬吊术治疗是一种可行、安全、有效的治疗方法。Objective:To explore the feasibility,safety,and clinical efficacy of laparoscopic sacrospinal ligament fixation combined with high hysterosacral ligament suspension for the treatment of middle pelvic organ prolapse.Methods:Thirty-two patients(31 cases of uterine prolapse and 1 case of vaginal vault prolapse after hysterectomy)received laparoscopic sacrospinal ligament fixation combined with high sacral ligament suspension.They were followed up regularly for 1,3,6,9,and 12 months after surgery.Results:All 32 cases of laparoscopic sacrospinal ligament fixation combined with high sacral ligament suspension surgery were successfully completed,including 31 cases of total hysterectomy,4 cases of posterior vaginal wall repair,5 cases of anterior vaginal wall repair,1 case of perineal body repair,and 1 case of middle urethral folding.The patient experienced bleeding of 50-150 mL during the surgery,with a surgical time of 90-150 min.The postoperative recovery time of gastrointestinal function was 1-3 days,the retention time of the urinary catheter was 1-3 days,and the hospitalization time was 4-9 days.Postoperative hip pain occurred in 2 cases without special treatment,and the pain and discomfort naturally relieved 3-4 days after surgery.The postoperative follow-up time was 1-24 months,and both the objective and subjective cure rates were 100%.Conclusions:For patients with pelvic organ prolapse,laparoscopic sacrospinal ligament fixation combined with high sacral ligament suspension is a feasible,safe,and effective treatment method.

关 键 词：腹腔镜手术 骶棘韧带固定术 高位骶韧带悬吊术 中盆腔器官脱垂 

分 类 号：R71[医药卫生—妇产科学]