腹腔镜下侧腹壁悬吊术与阴道后壁修补术联合治疗POP-QⅢ或Ⅳ期盆腔器官脱垂的效果分析  

Effect Analysis of Laparoscopic Lateral Abdominal Wall Suspension Combined with Posterior Vaginal Wall Repair in the Treatment of POP-QⅢ or Ⅳ Stage Pelvic Organ Prolapse

作　　者：李静[1] 曹艳花[1] 徐彩临[1] 陈颖[1] 王王莹 LI Jing;CAO Yanhua;XU Cailin;CHEN Ying;WANG Wangying(Department of Obstetrics and Gynecology,Xiamen Third Hospital,Xiamen 361002,China;不详)

机构地区：[1]厦门市第三医院妇产科,福建厦门361002

出　　处：《中国医学创新》2024年第27期1-5,共5页Medical Innovation of China

摘　　要：目的:探究腹腔镜下侧腹壁悬吊术联合阴道后壁修补术在盆腔器官脱垂定量分期法(POP-Q)Ⅲ或Ⅳ期盆腔器官脱垂患者中的应用效果。方法:选择2021年2月—2023年6月厦门市第三医院收治的90例POP-QⅢ或Ⅳ期盆腔器官脱垂患者,根据随机数字表法分为对照组和观察组,各45例。对照组进行阴式子宫切除术联合阴道前后壁修补术治疗,观察组则进行腹腔镜下侧腹壁悬吊术联合阴道后壁修补术治疗。比较两组的治疗总有效率、手术指标(手术时间、术中出血量、排气时间、住院时间)、并发症发生率、手术前后的盆底相关参数[阴道总长度(TVL)、阴道前壁中线离处女膜缘3 cm处(Aa)、前穹隆或阴道顶端到Aa点之间阴道前壁上段中距离处女膜的最远点(Ba)及宫颈或子宫切除后阴道顶端所处的最远端(C)]及盆底功能障碍问卷(PFDI-20)评分。结果:观察组治疗总有效率高于对照组,手术指标均优于对照组,并发症发生率显著低于对照组,差异均有统计学意义(P<0.05)。术后6个月,观察组盆底相关参数及PFDI-20各项评分均显著低于对照组,差异均有统计学意义(P<0.05)。结论:腹腔镜下侧腹壁悬吊术联合阴道后壁修补术在POP-QⅢ或Ⅳ期盆腔器官脱垂患者中的应用效果更好,可显著改善患者的盆底相关参数及盆底功能,且安全性较高。Objective:To investigate the application effect of laparoscopic lateral abdominal wall suspension combined with posterior vaginal wall repair in patients with pelvic organ prolapse in pelvic organ prolapse quantitation(POP-Q)ⅢorⅣstage.Method:A total of 90 patients with pelvic organ prolapse in POP-QⅢorⅣstage admitted to Xiamen Third Hospital from February 2021 to June 2023 were selected and divided into control group and observation group according to random number table method,with 45 cases in each group.The control group was treated with vaginal hysterectomy combined with posterior vaginal wall repair,and the observation group was treated with laparoscopic lateral abdominal wall suspension combined with posterior vaginal wall repair.The total effective rate,surgical indexes(operation time,intraoperative blood loss,exhaust time,length of hospital stay),complication rate,pelvic floor related parameters[total vaginal length(TVL),midline of the anterior vaginal wall from the hymen margin 3 cm(Aa),the most distant point of the upper section of the anterior wall of the vagina between the anterior fornix or the tip of the vagina and point Aa(Ba),farthest from the top of the vagina after cervicectomy(C)]and pelvic floor distress inventory-short form 20(PFDI-20)score before and after surgery were compared between the two groups.Result:The total effective rate of treatment in the observation group was higher than that in the control group,the surgical indicators were all better than those in the control group,and the incidence of complications was significantly lower than that in the control group,the differences were statistically significant(P<0.05).Six months after surgery,pelvic floor related parameters and PFDI-20 scores in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:The application of laparoscopic lateral abdominal wall suspension combined with posterior vaginal wall repair in patients with pelvic organ prol

关 键 词：腹腔镜下侧腹壁悬吊术 阴道后壁修补术 POP-QⅢ或Ⅳ期 盆腔器官脱垂 

分 类 号：R713[医药卫生—妇产科学]