摘要
目的:探讨腹腔镜下高位宫骶韧带悬吊术(HUS)与经阴道骶棘韧带固定术(SSLF)治疗年轻子宫脱垂患者的有效性和安全性。方法:对23例年轻子宫脱垂患者,随机分为两组行HUS和SSLF两种术式,采用POP-Q评估手术治疗效果,行生活及性生活质量评价。23例患者中,11例采用SSLF,其中9例为子宫脱垂Ⅲ度,2例为Ⅱ度;12例采用HUS术,其中9例为子宫脱垂Ⅲ度,2例为Ⅳ度,1例为Ⅱ度;HUS术中7例联合腹直肌固定术。结果:两种术式的出血量分别为50.0±10.5 ml、52.0±8.2 ml,手术时间分别为60.0±8.6分钟、64.0±9.6分钟,术后住院时间分别为4.2±0.8天、4.5±1.0天。术后随访时间均为24个月。术前两组患者子宫C点分别为+2.58±0.20 cm、+2.61±0.14 cm,D点-4.20±0.61 cm、-3.89±1.20 cm;术后C点-5.69±0.60 cm、-5.72±0.51 cm,D-7.00±0.30 cm、-6.88±0.32 cm,两组术前、术后比较,差异无统计学意义(P>0.05)。术后随访20例中18例患者术后性生活满意,生活质量评分手术前后差异有统计学意义(P<0.05)。结论:腹腔镜下高位宫骶韧带悬吊术和经阴道骶棘韧带固定术均是对要求保留子宫的年轻子宫脱垂患者安全有效的手术方式,且术后对性生活影响小。
Objective：To study the effectiveness and safety of high uterosacral ligament suspension and vaginal sacrospinous ligament fixation for treating the young patients with uterine prolapse, Methods：Twen- ty-three young patients with uterine prolapse during January 2007 to January 2009 in Foshan women and children healthcare hospital were randomly divided into two groups according to the different kinds of opera- tion（ HUS group and SSLF group）, POP-Q was used to assess outcomes of the operation, questionnaire was used to assess the patients＇ quality of sexual life. Results：Among the 23 cases,11 cases were carried out with vaginal sacrospinous ligament fixation and 12 cases with high uterosacral ligament suspension; a- mong the first 11 cases, 9 patients with Ⅲ degrees uterine prolapse and 2 patients with Ⅱ degrees uterine prolapse; among the other 12 cases,9 patients with Ⅲ degrees uterine prolapse, 2 cases with Ⅵ degrees u- terine prolapse and 1 cases with Ⅱ degrees uterine prolapse. There was 7 cases which were carried out with both HUS and rectus fixation. The bleeding of two groups operational ways was 50.0 ± 10.5 mt and 52.0 ± 8.2 ml respectively,the operational time was 60. 0 ±8.6 rain and 64. 0 ±9.6 min respectively;The time in hospital after operation was 4.2 ±0.8 d and 4.5 ± 1.0 d respectively; Following-up time after operation were 24 months. Before operation, the C point was at ＋2.58±0.20 cm and ±2.61±0, 14 respectively ,and D point was at -4.20 ±0. 61 cm and -3, 89± 1.20 cm respectively;after operation,the C point was at -5. 69 ±0. 60 cm and -5.72 ±0. 51 cm respectively and D point was -7.00 ±0.30 cm and -6.88 ±0.32 cm re- spectively,There was no significant difference on the preoperative and postoperative therapy effect among the two groups（ P 〉 0. 05）. Preoperative questionnaire for 20 patients showed that 18 patients were satisfied with their post-operative sexual life, there was significant difference between the preoperative and postopera- tive score of th
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2014年第4期273-277,共5页
Journal of Practical Obstetrics and Gynecology
关键词
高位宫骶韧带悬吊术
经阴道骶棘韧带固定术
子宫脱垂
High uterosacral ligament suspension
Vaginal sacrospinous ligament fixation
Uterine pro-lapse
