腹腔镜阴道残端悬吊术+修补术治疗重度SUP效果及复发观察  

Effect and recurrence of severe SUP treated with laparoscopic vaginal stump suspension and repair surgery

作　　者：王燕娇 苏丽芳 Wang Yan-jiao;Su Li-fang(Gynecology Department of Anxi Hospital,Quanzhou 362400,Fujian,China)

机构地区：[1]安溪县医院妇科,福建泉州362400

出　　处：《四川生理科学杂志》2025年第1期132-134,232,共4页

摘　　要：目的:探讨腹腔镜阴道残端腹壁悬吊术联合阴道前后壁修补术在治疗重度子宫脱垂(Severe uterine prolapse,SUP)中的疗效及其复发情况。方法:回顾性分析2021年5月至2023年5月安溪县医院收治的SUP患者临床资料,根据手术方式不同分为修补术式组(接受阴道前后壁修补术)和联合术式组(接受腹腔镜阴道残端腹壁悬吊术联合阴道前后壁修补术),经倾向性匹配评分最终筛选出每组54例。对比两组患者的围手术期指标,术前及术后采用盆腔器官脱垂评分(Pelvic organ prolapse-quantification,POP-Q)评估子宫脱垂程度,同时观察术后阴道残端水平、并发症发生情况以及术后一年内复发情况差异。结果:联合术式组的术中出血量和手术时间显著高于修补术式组(P<0.05);联合术式组的术后住院时间显著短于修补术式组(P<0.05),但两组在术后疼痛评分上无显著差异(P>0.05);联合术式组的POP-Q评分和阴道残端水平显著优于修补术式组(P<0.05);两组并发症发生率无显著差异(P>0.05);术后一年内,联合术式组的复发率显著低于修补术式组(P<0.05)。结论:腹腔镜阴道残端腹壁悬吊术联合阴道前后壁修补术与单纯修补术相比在治疗SUP中展现出良好的疗效和较低的复发率,安全性较好。Objective:To investigate the efficacy and recurrence of laparoscopic vaginal stump abdominal wall suspension combined with vaginal anterior and posterior wall repair in the treatment of severe uterine prolapse(SUP).Methods:Retrospective analysis of clinical data of SUP patients admitted to Anxi County Hospital from May 2021 to May 2023 was conducted.According to different surgical procedures,they were divided into a repair surgery group(receiving vaginal anterior and posterior wall repair surgery)and a combined surgery group(receiving laparoscopic vaginal stump abdominal wall suspension surgery combined with vaginal anterior and posterior wall repair surgery).A propensity score matching method was used to select 54 cases in each group.The perioperative indicators of the two groups of patients were compared.The degree of uterine prolapse was assessed using the Pelvic Organ Prolapse-Quantification(POP-Q)scale before and after surgery.Additionally,the differences in vaginal stump level,complication occurrence,and recurrence within one year after surgery were observed.Results:The intraoperative blood loss and operation time in the combined surgery group were significantly higher than those in the repair surgery group(P<0.05).The postoperative hospitalization time in the combined surgery group was significantly shorter than that in the repair surgery group(P<0.05),but there was no significant difference in postoperative pain scores between the two groups(P>0.05).The POP-Q score and vaginal stump level in the combined surgery group were significantly better than those in the repair surgery group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Within one year after surgery,the recurrence rate in the combined surgery group was significantly lower than that in the repair surgery group(P<0.05).Conclusion:Compared with simple repair,laparoscopic vaginal stump abdominal wall suspension combined with vaginal anterior and posterior wall repair shows good efficacy and

关 键 词：重度子宫脱垂 腹腔镜阴道残端腹壁悬吊术 阴道前后壁修补术 疗效 复发情况 

分 类 号：R65[医药卫生—外科学]