经阴道骶棘韧带固定术联合传统阴式手术治疗中重度盆腔器官脱垂的临床疗效  

Clinical effect of transvaginal sacrospinous ligamentopexy combined with traditional per-vaginam surgery in the treatment of moderate and severe pelvic organ prolapse

作　　者：郭娟 刘艳 邵琰玉 王一娜[1] 许洁[1] Guo Juan;Liu Yan;Shao Yanyu;Wang Yina;Xu Jie(Department of Obstetrics and Gynecology,the Third People's Hospital of Yancheng,Yancheng 224000,China)

机构地区：[1]盐城市第三人民医院妇产科,盐城224000

出　　处：《中国医师杂志》2024年第11期1691-1694,1699,共5页Journal of Chinese Physician

摘　　要：目的探讨经阴道骶棘韧带固定术联合传统阴式手术治疗中重度盆腔器官脱垂的疗效。方法回顾性选取2021年6月至2023年5月盐城市第三人民医院收治的125例中重度盆腔器官脱垂患者为研究对象, 据手术方式分为两组, 观察组(73例)采用经阴道骶棘韧带固定术联合传统阴式手术, 对照组(52例)采用传统阴式手术, 主要结局比较两组解剖治愈率, 次要结局为手术指标、生活质量及复发情况。结果观察组和对照组术后6个月解剖治愈率[78.1%(57/73) vs 61.5%(32/52)]、术后住院时间比较差异有统计学意义(均P<0.05);两组手术时间、手术出血量及术后24 h疼痛程度差异无统计学意义(均P>0.05)。术前两组盆底功能障碍问卷-20(PFDI-20)评分差异无统计学意义(P>0.05);术后6个月两组PFDI-20评分均低于术前, 且观察组术后PFDI-20评分低于对照组, 差异有统计学意义(P<0.05)。术后随访患者, 观察组3例(8.3%)复发, 对照组6例(13.3%)复发, 两组术后复发率差异无统计学意义(P>0.05)。结论经阴道骶棘韧带固定术联合传统阴式手术可有效治疗中重度盆腔器官脱垂, 提高患者生活质量, 且远期效果较好。Objective To investigate the curative effect of transvaginal sacrospinous ligamentopexy combined with traditional per-vaginam surgery in the treatment of moderate and severe pelvic organ prolapse.Methods A total of 125 patients with moderate to severe pelvic organ prolapse admitted to the Third People's Hospital of Yancheng from June 2021 to May 2023 were retrospectively selected as the study objects.They were divided into two groups according to the surgical methods.The observation group(73 cases)received transvaginal sacrospinous ligamentopexy combined with traditional per-vaginam surgery,and the control group(52 cases)received traditional Yin surgery.The primary outcome was anatomic cure rate between the two groups,and the secondary outcome was surgical index,quality of life and recurrence.Results There were significant differences in the anatomical cure rate[78.1%(57/73)vs 61.5%(32/52)] and postoperative hospital stay between the observation group and the control group at 6 months after surgery(all P<0.05).There was no significant difference in operation time,amount of blood loss and pain degree 24 h after operation between the two groups(P>0.05).There was no significant difference in Pelvic Floor Distress Inventory-Short Form 20(PFDI-20)scores between the two groups before operation(P>0.05).PFDI-20 scores in both groups were lower than those before surgery 6 months after surgery,and PFDI-20 scores in the observation group were lower than those in the control group,with statistical significance(P<0.05).After follow-up,3 cases(8.3%)recurred in the observation group and 6 cases(13.3%)in the control group.There was no statistical significance in the recurrence rate between the two groups(P>0.05).Conclusions Transvaginal sacrospinous ligamentopexy combined with traditional per-vaginam surgery can effectively treat moderate and severe pelvic organ prolapse,improve the quality of life of patients,and have a good long-term effect.

关 键 词：盆腔器官脱垂 经阴道骶棘韧带固定术 

分 类 号：R713[医药卫生—妇产科学]