腹腔镜髂耻韧带悬吊术与腹腔镜骶骨韧带固定术治疗中盆腔器官脱垂疗效比较  

Efficacy of Laparoscopic Pectopexy and Laparoscopic Sacrocolpopexy in the Treatment of Middle Compartment Pelvic Organ Prolapse:A Comparison

作　　者：王真真 周媛 田静 沈雪 WANG Zhen-zhen;ZHOU Yuan;TIAN Jing;SHEN Xue(Department of Obstetrics and Gynecology,2Medical Records Department,Xiangyang No.1 People's Hospital,Hubei Univer-sity of Medicine,Xiangyang,Hubei 441000,China)

机构地区：[1]湖北医药学院附属襄阳市第一人民医院妇产科,湖北襄阳441000 [2]湖北医药学院附属襄阳市第一人民医院病案统计科,湖北襄阳441000

出　　处：《湖北医药学院学报》2025年第1期35-41,共7页Journal of Hubei University of Medicine

基　　金：湖北省自然科学基金(2022CFB341);襄阳市第一人民医院科技创新项目(XYY2021Q14)。

摘　　要：目的:探讨腹腔镜髂耻韧带悬吊术(LP)与腹腔镜骶骨韧带固定术(LSC)治疗女性中盆腔器官脱垂的短期疗效及安全性。方法:回顾性分析2022年10月至2023年10月在襄阳市第一人民医院收治的62例中盆腔器官脱垂(POP-Q)评分≥Ⅱ度患者的临床资料,按照手术方式将其分为实验组(LP,n=32)和对照组(LSC,n=30),通过比较术前及术后6个月POP-Q中Aa、Ba、C、Ap、Bp点的位置以及阴道总长度(TVL)、盆底功能障碍性疾病症状问卷-20(PFDI-20)和盆底功能影响问卷简表-7(PFIQ-7)来评价客观治愈率和主观生活质量,并观察手术并发症情况。结果:实验组的手术时间、术中出血量、住院天数、留置尿管时间短于对照组,差异具有统计学意义(P<0.05);与术前相比,两组术后6个月Aa、Ba、C、Ap、Bp指示点的测量值均得到改善,差异具有统计学意义(P<0.01),而TVL差异均无统计学意义;两组术后6个月生活质量评分PFDI-20及PFIQ-7较术前相比,差异均有统计学意义(P<0.05),组间比较差异无统计学意义。结论:腹腔镜髂耻韧带悬吊术是治疗中盆腔器官脱垂的新术式,具有手术时间短,术中出血及住院天数少,留置尿管时间及术后并发症少的优点,为临床医生提供了一种更安全、可靠、有效的手术选择。Objective To discuss the short-term efficacy and safety of laparoscopic pectopexy(LP)and laparoscopic sacro⁃colpopexy(LSC)in the treatment of middle compartment pelvic organ prolapse.Methods A retrospective analysis was con⁃ducted on the clinical data of 62 patients with middle compartment pelvic organ prolapse(POP-Q stage≥Ⅱ)treated at Xiangyang No.1 People's Hospital from October 2022 to October 2023.Patients were stratified by surgical method into two groups:the LP group(n=32)and the LSC group(n=30).Objective cure rate and subjective quality of life were assessed by comparing preoperative and 6-month postoperative POP-Q points(Aa,Ba,C,Ap,and Bp),total vaginal length(TVL),and the Pelvic Floor Distress Inventory-20(PFDI-20)and the Pelvic Floor Impact Questionnaire-7(PFIQ-7)scores.Intraoperative and postoperative complications were also documented to evaluate surgical safety.Results The LP group had shorter operative time,reduced intraoperative blood loss,shorter hospital stays,and shorter catheterization time than those in the LSC group(P<0.05).At 6 months postoperatively,both groups had significant improvement in the POP-Q points Aa,Ba,C,Ap,and Bp compared with preoperative values(P<0.01),while changes in TVL were not distinct.Additionally,the two groups demonstrated marked improvements in the PFDI-20 and PFIQ-7 scores after 6-month opera⁃tion compared with preoperative scores(P<0.05),and no intragroup difference was observed.Conclusion LP is a new surgical technique for treating middle compartment pelvic organ prolapse,offering advantages such as short operative time,reduced intraoperative blood loss,short hospital stay,decreased catheterization time,and few postoperative complications.It provides a safe,reliable,and effective surgical option in clinical practice.

关 键 词：盆腔器官脱垂 腹腔镜髂耻韧带悬吊术 盆腔器官脱垂定量分度法 

分 类 号：R713[医药卫生—妇产科学]