摘要
目的分析经阴道前盆底重建术联合骶棘韧带吊带固定术治疗盆腔脏器脱垂的疗效及安全性。方法对50例盆腔脏器脱垂患者采取经阴道前盆底重建术联合骶棘韧带吊带固定术治疗,比较患者术前及术后6个月盆腔脏器脱垂评估指示点评分及盆底功能障碍问卷(PFDI-20)评分,观察患者预后情况。结果术后6个月,患者盆腔脏器脱垂评估指示点Aa、Ba、C、Ap、Bp评分均优于术前,差异有统计学意义(P<0.05)。术后6个月,患者PFDI-20评分为(11.34±5.10)分优于术前的(67.62±19.01)分,差异有统计学意义(P<0.05)。患者术后均无感染,无膀胱及肠管损伤。术后1例患者发生膀胱残余尿量增多,1例患者发生盆腔穿刺路径血肿,均经治疗后好转。随访至术后24个月时,1例患者出现阴道前壁膨出复发,复发率为2%(1/50)。患者均无网片侵袭外露发生。结论经阴道前盆底重建术联合骶棘韧带吊带固定术治疗盆腔脏器脱垂是一种安全有效的手术方式,可有效改善患者的生活质量,降低脱垂复发的风险,并发症少,恢复快,近期疗效明显,值得临床推广。
Objective To analyze the efficacy and safety of transvaginal anterior pelvic floor reconstruction combined with sacrospinous ligament fixation in the treatment of pelvic organ prolapse.Methods 50 patients with pelvic organ prolapse were treated with transvaginal anterior pelvic floor reconstruction combined with sacrospinous ligament fixation,and the prognosis was observed by comparing their pelvic organ prolapse quantification scores and pelvic floor distress inventory-short form-20(PFDI-20) scores before operation and 6 months after operation.Results At 6 months after operation,the pelvic organ prolapse quantification scores at Aa,Ba,C,Ap,and Bp of patients were better than those before operation,and the difference was statistically significant(P<0.05).At 6 months after operation,the PFDI-20 score(11.34±5.10) points was better than(67.62±19.01) points before operation,and the difference was statistically significant(P<0.05).There was no postoperative infection,and no bladder and bowel injuries in patients.After operation,1 patient had an increase in the residual urine volume of the bladder,and 1 patient had a hematoma of the pelvic puncture path,all of which improved after treatment.After 24 months of follow-up,1 patient had a recurrence of vaginal bulge,and the recurrence rate was 2%(1/50).No mesh invasion and exposure occurred in patients.Conclusion Transvaginal anterior pelvic floor reconstruction combined with sacrospinous ligament fixation is a safe and effective method for the treatment of pelvic organ prolapse,which can effectively improve patients’ quality of life and reduce the risk of recurrence of prolapse,with few complications,rapid recovery and significant recent efficacy,and is worthy of clinical promotion.
作者
曲思娆
赵曼曼
李芳
李全红
QU Si-rao;ZHAO Man-man;LI Fang(Department of Gynecology,Shenyang Fourth People’s Hospital,Shenyang 110031,China)
出处
《中国实用医药》
2022年第4期41-43,共3页
China Practical Medicine
关键词
盆腔脏器脱垂
骶棘韧带吊带固定术
经阴道前盆底重建术
Pelvic organ prolapse
Sacrospinous ligament fixation
Transvaginal anterior pevic floor reconstruction
