摘要
目的:探讨腹腔镜下高位宫骶韧带悬吊术治疗盆腔器官脱垂的疗效和安全性。方法:2017年3月—2019年3月选择上海市第四人民医院及上海市长宁区妇幼保健院妇科收治的POP-Q分期II-III度盆腔器官脱垂患者116例,随机分为两组,研究组56例采用腹腔镜下子宫全切术+高位宫骶韧带悬吊术,对照组60例采用阴式全子宫切除术+阴道前后壁修补术60。分别比较两组患者手术参数、POP指示点以及盆底疾病生活影响问卷-简易版7(PFIQ-7)等的改变。结果:研究组和对照组手术时间分别为(123.5±46.3)min及(82.5±20.6)min,差异有统计学意义(t=4.712,P<0.05);术中出血量分别为(100.5±50.5)mL及(90.7±45.6)mL,术后留置尿管时间分别为(3.2±1.5)天及(3.6±1.8)天,住院天数分别为(5.2±1.4)天及(5.6±1.5)天,以上指标两组比较差异均无统计学意义(P值均>0.05)。术后PFIQ-7评分研究组为(2.54±1.23)分、对照组为(3.58±2.23)分,差异无统学意义(P>0.05);PFDI-20评分研究组为(3.07±2.49)分、对照组为(5.12±3.09)分,差异有统计学意义(t=-3.917,P<0.05);PISQ-12评分研究组为(52.15±18.87)分、对照组(32.33±13.58)分,差异有统计学意义(t值分别为-3.145、-3.527、-2.190、-2.362、-4.589、2.267,P<0.05)。结论:腹腔镜下高位宫骶韧带悬吊术治疗POP-Q分期II-III度盆腔器官脱垂是一种安全、有效的术式,具有较好的解剖及功能疗效。
OBJECTIVE To evaluate the effectiveness and safety of laparoscopic highuterosacral ligament suspension in the treat⁃ment of pelvic organ prolapse.METHODS 116 patients with POP-Q stage II-III from March 2017 to March 2019 in Shanghai Fourth People’s Hospital and Shanghai Changning District Women and Infant Health Hospital were randomly divided into two groups:56 patients in the study group were treated with laparoscopic highuterosacral ligament suspension and 60 patients in the con⁃trol group were treated with transvaginal total hysterectomy plus anterior and posterior repair.The operative parameters,POP indica⁃tor points and functional effects were evaluated according to the Pelvic Floor Impact Questionnaire-simple version 7(PFIQ-7),re⁃spectively.RESULTS The operation time of the study group and the control group were(123.5±46.3)min and(82.5±20.6)min respectively,and the difference was statistically significant(t=4.712,P<0.05).The bleeding volume was(100.5±50.5)ml and(90.7±45.6)mL,the indwelling catheter was(3.2±1.5)days and(3.6±1.8)days,and the hospitalization days were(5.2±1.4)days and(5.6±1.5)days,respectively.There were no statistical significance between the two groups.The PFIQ-7 score was(2.54±1.23)in the study group and(3.58±2.23)in the control group(P>0.005);the PFDI-20 score was(3.07±2.49)in the study group and(5.12±3.09)in the control group(t=-3.917,P<0.05);the PISQ-12 score was(52.15±18.87)in the study group and(32.33±13.58)in the control group(t=-3.145,-3.527,-2.190,-2.362,-4.589,2.267,P<0.05).CON⁃CLUSION Laparoscopic highuterosacral ligament suspension was a safe and effective method for the treatment of POP-Q stage II-III,which had good anatomical and functional effects.
作者
黄永芳
刘平
张文缨
吴琼蔚
HUANG Yong-fang;LIU Ping;ZHANG Wen-ying;WU Qiong-wei(Department of Obstetrics and Gynecology,Shanghai Fourth People’s Hospital,Shanghai,200081,China)
出处
《中国初级卫生保健》
2021年第8期84-87,共4页
Chinese Primary Health Care
基金
上海市长宁区卫生健康委创新团队项目(2018169)。
关键词
盆腔器官脱垂
腹腔镜
高位宫骶韧带悬吊术
pelvic organ prolapse
laparoscopy
highuterosacral ligament suspension
