v-NOTES骶棘韧带固定术治疗中盆腔器官脱垂的疗效分析  

Efficacy analysis of v-NOTES sacrospinous ligament fixation in the treatment of pelvic organ prolapse

作　　者：汪香梅 王艳 丁锦 WANG Xiangmei;WANG Yan;DING Jin(Department of Obstetrics and Gynecology,Lujiang County People's Hospital,Hefei,Anhui 231500,China;Department of Obstetrics and Gynecology,The First Affiliated Hospital of Wannan Medical College,Wuhu,Anhui 241001,China)

机构地区：[1]安徽省合肥市庐江县人民医院妇产科,安徽合肥231000 [2]皖南医学院第一附属医院妇产科,安徽芜湖241001

出　　处：《手术电子杂志》2024年第5期24-28,44,共6页Electronic Journal of Medical Operations

基　　金：芜湖市科技计划成果转化项目(2022cg26);2022年院引进人才科研基金(YR20220220)

摘　　要：目的 探讨阴道自然腔道内镜手术(v-NOTES)骶棘韧带固定术治疗盆腔器官脱垂的可行性及优势。方法 选取本院2021年1月—2022年8月收治的110例盆腔器官脱垂(POP)患者为研究对象,随机分为研究组与对照组各55例,研究组实施v-NOTES骶棘韧带固定术,对照组实施传统经阴道子宫切除术+高位骶韧带悬吊。记录手术时间(min)、术中出血量(mL)、术后住院时间(d)、并发症情况及治愈率等,门诊随访患者术后1、6、12、24个月的主观感受(PFDI-20、PFIQ-7评分)及客观指标(POP-Q分度)等。结果 110例手术均成功实施,无术中并发症发生。研究组平均手术时间(102.24±10.62)min、平均术中出血量(143.27+79.13)m L,术后平均住院天数(5.77±1.42)d;术后1、6、12、24个月随访,患者均无阴道脱垂复发,POP-Q评分、PFDI-20、PFIQ-7评分均优于术前。与对照组相比,研究组手术时间延长(P<0.05);术后12个月研究组的Ba点、C点较对照组改善明显,差异有统计学意义(P<0.05)。结论 v-NOTES骶棘韧带固定术是一种安全、可行的手术方式,可精准暴露、缝合骶棘韧带,中短期疗效可靠。Objective To investigate the feasibility and advantages of v-NOTES sacrospinous ligament fixation for the treatment of pelvic organ prolapse(POP).Methods One hundred and ten patients with POP were selected for the study from January 2021 to August 2022 and randomly divided into the study group and the control group.v-NOTES sacrospinous ligament fixation was performed in the study group,and traditional transvaginal hysterectomy+high uterosacral ligament suspension was performed in the control group.The operation time(min),intraoperative bleeding(mL),postoperative hospitalization time(d),complications and cure rate were recorded.The outpatient follow up for subjective feelings(PFDI-20 and PFIQ-7 scores)and objective indicators(POP-Q staging)was conducted for postoperative periods of 1,6,12 and 24 months.Results All 110 surgeries were successfully performed without intraoperative complications.In the study group,the average operation time was(102.24±10.62)min,the average intraoperative bleeding was(143.27±79.13)mL,and the average number of days of hospitalization after surgery was(5.77±1.42)days.The patients had no recurrence of vaginal prolapse in the postoperative follow-ups at 1,6,12,and 24 months,and the POP-Q,PFDI-20 and PFIQ-7 scores improved significantly compared with those before surgery.Compared with the control group,the duration of surgery was prolonged in the study group(P<0.05).The Ba point and C point of the study group improved significantly compared with the control group at 12 months after surgery,and the difference was statistically significant.Conclusion v-NOTES sacrospinous ligament fixation is a safe and feasible surgical procedure that can precisely expose and suture the sacrospinous ligament with reliable short-term efficacy.

关 键 词：盆腔器官脱垂 经自然腔道内镜手术 骶棘韧带固定术 单孔腹腔镜 手术 

分 类 号：R71[医药卫生—妇产科学]