摘要
本研究探讨了Lasso缝合钩在经阴道骶棘韧带固定术中应用的可行性和安全性。回顾性纳入2018年1月至2021年1月于苏州大学附属第二医院应用Lasso缝合钩行经阴道骶棘韧带固定术的38例阴道顶端脱垂Ⅱ度以上患者,年龄46~75(62.7±12.5)岁,在充分显露右侧骶棘韧带后,用Lasso缝合钩带聚丙烯缝线将宫颈/宫骶韧带缝合在骶棘韧带上。观察手术完成情况、术中并发症、手术时间、出血量、术后情况,并随访术后客观治愈率及主观满意率。38例患者用Lasso缝合钩均顺利完成了经阴道骶棘韧带固定术,术中均无膀胱直肠损伤,无盆腔血肿发生。手术时间为15~40(24±9.5)min,术中出血为20~60(40±12.5)ml,术后第1天疼痛视觉模拟评分(VAS)为3~5(3.2±1.4)分,术后第3天疼痛VAS评分为2~4(2.2±1.8)分,术后无臀部下肢麻木疼痛发生。术后3个月随访结果显示,术后盆腔器官脱垂定量分期法(POP-Q)评分客观手术成功率为100%(38/38)。术后12个月随访结果显示,术后POP-Q评分客观手术治愈率为92.1%(35/38)。盆底不适调查表简表(PFDI-20)评分术前为42~180(120.4±44.9)分、术后为8~75(28.0±14.3)分(P<0.001);盆底功能影响问卷简表(PFIQ-7)评分术前为52~214(112.8±44.5)分、术后为5~29(14.3±6.0)分(P<0.001);患者整体印象改善量表(PGI-I)评估患者主观满意率为89.5%(34/38)。应用Lasso缝合钩行经阴道骶棘韧带固定术是简便安全可行的。
To investigate the feasibility and safety of the Lasso suture hook in transvaginal sacrospinous ligament fixation,a total of 38 patients with vaginal vault prolapse at or above stageⅡ,and aged 46-75(62.7±12.5)years,who underwent transvaginal sacrospinous ligament fixation at the Second Affiliated Hospital of Soochow University from January 2018 to January 2021 were retrospectively analyzed.After complete exposure of the right sacrospinous ligament,the cervical/uterosacral ligament was sutured to the sacrospinous ligament using Lasso hook and polypropylene sutures.The completion rate of the operation,intraoperative complications,operation time,blood loss,and postoperative situations were observed,and the objective cure rate and subjective satisfaction were followed up.Transvaginal sacrospinous ligament fixation was successfully performed in all 38 patients using Lasso suture hooks.There were no bladder or rectum injuries during the operations,and no pelvic hematoma occurred.The operation time was 15-40(24±9.5)min;the intraoperative bleeding was 20-60(40±12.5)ml;the visual analogue scale(VAS)score was 3-5(3.2±1.4)points on the first day of postoperative,and 2-4(2.2±1.8)points on the third day of postoperative.No numbness or pain in buttocks and lower limbs after the operation.The 3-month follow-up results showed that the objective surgical success rate of the postoperative pelvic organ prolapse quantitation(POP-Q)score was 100%(38/38).The 1-year follow-up results showed that the objective surgical cure rate of postoperative POP-Q score was 92.1%(35/38).The score of Pelvic Floor Distress Inventory-Short Form 20(PFDI-20)was 42-180(120.4±44.9)before operation and 8-75(28.0±14.3)after operation(t=15.90,P<0.001);The score of Pelvic Floor Function Impact Questionnaire-Short Form7(PFIQ-7)was 52-214(112.8±44.5)before operation and 5-29(14.3±6.0)after operation(t=14.40,P<0.001),and the subjective satisfaction rate is 89.5%(34/38)conducted by Patient Global Impression of Improvement(PGI-I).Transvaginal sacrospinou
作者
郭亮生
郑丽君
戴淑榕
张思佳
Guo Liangsheng;Zheng Lijun;Dai Shurong;Zhang Sijia(Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Soochow University,Suzhou 215004,China;Department of Ultrasound,the Second Affiliated Hospital of Soochow University,Suzhou 215004,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2023年第36期2889-2892,共4页
National Medical Journal of China
基金
江苏省卫生健康委员会科研项目(F201922)
苏州市科技计划项目(SLJ2022018,SYS2020134)
苏州市卫生健康委员会科研项目(GSWS2020028)
放射医学与辐射防护国家重点实验室项目(GZK1202140)
