腹膜外无张力吊带子宫悬吊术治疗盆腔脏器脱垂的疗效  

The therapeutic effect of extraperitoneal tension-free uterine suspension in the treatment of pelvic organ prolapse

作　　者：唐虹 周奇 欧阳晓玲 王永峰 华宇 郝小白 李林霞 Tang Hong;Zhou Qi;Ouyang Xiaoling;Wang Yongfeng;Hua Yu;Hao Xiaobai;Li Linxia(Department of Obstetrics and Gynecology,the Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China)

机构地区：[1]上海中医药大学附属第七人民医院妇产科,200137

出　　处：《中华疝和腹壁外科杂志（电子版）》2024年第3期315-319,共5页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

基　　金：浦东新区重点专科建设项目(PWZzk2022-14);上海市卫生健康委科研项目(202140279)。

摘　　要：目的探讨腹腔镜下腹膜外无张力吊带子宫悬吊术(laparoscopic extraperitoneal tension-free uterine suspension,LETUS)与阴道骶骨固定术(LVSC)治疗盆腔脏器脱垂(POP)的临床疗效。方法选取上海中医药大学附属第七人民医院2022年1月1日至2023年6月1日92例POP患者,随机数字表法分为观察组(n=46)及对照组(n=46)。对照组行LVSC,观察组行LETUS。对比2组手术指标、手术前后盆腔器官脱垂定量分度法(POP-Q)指标、盆底功能[盆底功能障碍问卷-7(PFIQ-7)、盆腔脏器脱垂尿失禁性生活问卷-12(PISQ-12)]、盆底肌力、并发症。结果观察组术中出血量、手术及住院时间均少于对照组[(50.23±8.74)ml比(82.06±13.52)ml;(206.81±30.96)min比(272.49±42.07)min;(5.72±0.84)d比(7.06±1.09)d](P<0.001);术后6个月,2组C、Aa、Ap、Ba、Bp均优于术前(P<0.05),但2组间比较差异无统计学意义(P>0.05);术后6个月,观察组PFIQ-7评分低于对照组[(16.26±3.93)分比(25.60±4.45)分],PISQ-12评分高于对照组[(38.94±4.42)分比(34.51±4.03)分](P均<0.001);术后6个月,观察组肌电位、静态张力、动态张力均高于对照组[(15.01±2.26)μV比(12.43±1.87)μV;(159.30±22.08)g/cm^(2)比(137.84±24.31)g/cm^(2);(234.26±29.62)g/cm^(2)比(202.31±26.98)g/cm^(2)](P均<0.001);观察组并发症发生率低于对照组(P=0.044)。结论LETUS与LVSC治疗POP均具有良好的疗效,但LETUS能缩短术后恢复时间,改善盆底功能,提高盆底肌力,减少并发症。Objective To explore the clinical curative effect of laparoscopic extraperitoneal tension-free uterine suspension(LETUS)and laparoscopic vaginal sacral colpopexy(LVSC)in the treatment of pelvic organ prolapse(POP).Methods A total of 92 patients with POP in the Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine were enrolled and divided into an observation group(n=46)and a control group(n=46)between January 1,2022 and June 1,2023 by random number table method.The control group was treated with LVSC,while the observation group was treated with LETUS.The surgical indexes,pelvic organ prolapse quantitation(POP-Q)indexes,pelvic floor function,pelvic floor muscle strength and complications were compared between the two groups before and after surgery.Results The intraoperative blood loss,operation time and hospitalization time in the observation group were lower than those in the control group[(50.23±8.74)ml vs(82.06±13.52)ml,(206.81±30.96)min vs(272.49±42.07)min,(5.72±0.84)d vs(7.06±1.09)d;P<0.001].At 6 months after surgery,C,Aa,Ap,Ba and Bp were improved in both groups(P<0.05),but there was no significant difference between the two groups(P>0.05).At 6 months after surgery,the PFIQ-7 score was lower in the observation group than the control group,and the PISQ-12 score was higher in the observation group than the control group[(16.26±3.93)points vs(25.60±4.45)points,(38.94±4.42)points vs(34.51±4.03)points;P<0.001].At 6 months after surgery,muscle potential,static tension and dynamic tension were higher in the observation group than the control group[(15.01±2.26)μV vs(12.43±1.87)μV,(159.30±22.08)g/cm^(2)vs(137.84±24.31)g/cm^(2),(234.26±29.62)g/cm^(2)vs(202.31±26.98)g/cm^(2);P<0.001].The incidence of complications in observation group was lower than that in control group(P=0.044).Conclusion The curative effect of both LETUS and LVSC is good in POP.However,the former can shorten postoperative recovery time,improve pelvic floor function,enhance pelvic floor muscle

关 键 词：盆腔脏器脱垂 腹腔镜 腹膜外无张力吊带子宫悬吊术 阴道骶骨固定术 临床疗效 

分 类 号：R713[医药卫生—妇产科学]