经阴道骶棘韧带悬吊术联合阴式子宫全切除术治疗重度盆腔脏器脱垂患者的效果  

Effects of transvaginal sacrospinous ligament suspension combined with transvaginal hysterectomy in treatment of patients with severe pelvic organ prolapse

作　　者：王凤霞 WANG Fengxia(Department of Obstetrics and Gynecology of Luyi County People’s Hospital,Zhoukou 477200 Henan,China)

机构地区：[1]鹿邑县人民医院妇产科,河南周口477200

出　　处：《中国民康医学》2025年第3期77-80,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察经阴道骶棘韧带悬吊术联合阴式子宫全切除术(TVH)治疗重度盆腔脏器脱垂(POP)患者的效果。方法:选取2022年2月至2023年2月该院收治的62例重度POP患者进行前瞻性研究,采用随机数字表法将其分为对照组和观察组各31例。对照组行TVH治疗,观察组行经阴道骶棘韧带悬吊术联合TVH治疗,比较两组围手术期指标(术中失血量、手术时间、排气时间、住院时间)水平,手术前后脱垂距离、生命质量[盆底功能障碍问卷表(PFDI-20)]评分和性生活质量[POP定量分度(POP-Q)/尿失禁性生活问卷-12(PISQ-12)]评分,以及术后3 d内并发症发生率。结果:观察组手术时间长于对照组,术中出血量多于对照组,差异均有统计学意义(P<0.05);两组排气时间和住院时间比较,差异均无统计学意义(P>0.05);术后,两组阴道前壁、后壁、顶部等POP-Q测量值均小于术前,且观察组小于对照组,差异有统计学意义(P<0.05);术后,两组PFDI-20、PISQ-12评分均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:经阴道骶棘韧带悬吊术联合TVH治疗重度POP患者可减小脱垂距离,降低PFDI-20和PISQ-12评分,效果优于单纯TVH治疗,但会延长手术时间,增加术中出血量。Objective:To observe effects of transvaginal sacrospinous ligament suspension combined with transvaginal hysterectomy(TVH)in treatment of patients with severe pelvic organ prolapse(POP).Methods:A prospective study was conducted on 62 patients with severe POP admitted to the hospital from February 2022 to February 2023.They were divided into control group and observation group by using the random number table method,31 cases in each group.The control group was treated with TVH,while the observation group was treated with transvaginal sacrospinous ligament suspension combined with TVH.The perioperative indexes(intraoperative blood loss,operation time,exhaust time,hospitalization time)levels,the prolapse distance before and after the surgery,the quality of life[pelvic floor dysfunction inventory(PFDI-20)]and quality of sexual life[POP quantitative indexing(POP-Q)/urinary incontinence sexual questionnaire-12(PISQ-12)]scores,and the incidence of complications within 3 days after the surgery were compared between the two groups.Results:The operation time of the observation group was longer than that of the control group,the intraoperative blood loss was more than that of the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the exhaust time and the hospitalization time between the two groups(P>0.05).After the surgery,the POP-Q measurement values of the anterior,posterior and top of the vagina in the two groups were smaller than those before the surgery,those in the observation group were smaller than those in the control group,and the differences were statistically significant(P<0.05).After the surgery,the scores of PFDI-20 and PISQ-12 in the two groups were lower than those before the surgery,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:Transvaginal

关 键 词：盆腔脏器脱垂 经阴道骶棘韧带悬吊术 阴式子宫全切除术 并发症 生命质量 性生活质量 

分 类 号：R713[医药卫生—妇产科学]