腹腔镜下全子宫切除联合阴道残端腹壁悬吊术治疗中重度子宫脱垂的疗效观察  

Clinical effect of laparoscopic total hysterectomy combining with vaginal stump suspension in the treatment of moderate and severe uterine prolapse

作　　者：高淑婷 元春燕 GAO Shuting;YUAN Chunyan(Banyannur Hospital,Banyannur 015000,China;The People’s Hospital of Linhe District in Bayannur City)

机构地区：[1]巴彦淖尔市医院,内蒙古巴彦淖尔015000 [2]巴彦淖尔市临河区人民医院

出　　处：《包头医学院学报》2024年第7期73-75,92,共4页Journal of Baotou Medical College

摘　　要：目的:探讨腹腔镜下全子宫切除联合阴道残端腹壁悬吊术在治疗中重度子宫脱垂患者的临床应用情况。方法:回顾性分析2021年1月至2023年4月在巴彦淖尔市医院接受腹腔镜下全子宫切除联合阴道残端腹壁悬吊术治疗中重度子宫脱垂60例患者临床资料,根据手术时间、术中出血量、住院时间、术后并发症发生率以及术后12个月随访情况,评估此术式的临床应用情况。结果:60例患者均顺利完成腹腔镜下全子宫切除联合阴道残端腹壁悬吊术,平均手术时间为(90.2±12.5)min,平均术中出血量为(50.8±14.6)mL,平均住院时间为(5.1±1.4)d;2例出现术后并发症,其中1例阴道残端感染,1例短暂性尿潴留,并发症发生率为3.3%(2/60)。所有患者分别在术后1、3、6、12个月进行电话及门诊随访,其中术后12个月失访2例,其余58例患者均未出现子宫脱垂复发,且随着时间的推移,患者的情况逐渐达标,相较术前生活质量得到提升(P<0.05);患者术后症状改善,总体满意度评分较高。结论:腹腔镜下全子宫切除联合阴道残端腹壁悬吊术是治疗中重度子宫脱垂的有效手术方法,随着时间推移,患者术后症状改善、生活质量、满意度均较好。Objective:To investigate the clinical effect of laparoscopic total hysterectomy combining with vaginal stump suspension in the treatment of moderate and severe uterine prolapse.Methods:The clinical data of 60 patients with moderate and severe uterine prolapse who underwent laparoscopic hysterectomy combining with vaginal stump suspension in Banyannur Hospital from January 2021 to April 2023 were retrospectively analyzed.The clinical efficacy of this surgical method was evaluated based on the operative time,intraoperative blood loss,length of hospital stay(LOS),postoperative complications and results of 12-month follow-up.Results:All surgeries were successfully completed,with the average operative time of(90.2±12.5)min,the average intraoperative blood loss of(50.8±14.6)mL,and the average LOS of(5.1±1.4)d.There were 1 case of vaginal stump infection and 1 case of transient urinary retention,and the complication rate was 3.3%(2/60).All patients were followed up at 1 month,3 months,6 months and 12 months after surgery by telephone and outpatient examination.Among them,2 cases were lost to follow-up at 12 months,and no recurrence of uterine prolapse occurred in the remaining 58 patients.With the passage of time,the patient’s condition gradually reached the normal standard,and the quality of life was significantly improved compared with that before surgery(P<0.05).The overall satisfaction and postoperative symptoms were significantly improved.Conclusion:Laparoscopic hysterectomy combining with vaginal stump suspension is an effective surgical method in treating moderate and severe uterine prolapse,which has the advantages of shorter operative time,less intraoperative bleeding,faster postoperative recovery and fewer complications.With the passage of time,the postoperative symptoms,quality of life and satisfaction of patients were significantly improved.

关 键 词：腹腔镜手术 全子宫切除 阴道残端腹壁悬吊术 子宫脱垂 

分 类 号：R713.4[医药卫生—妇产科学]