骶棘韧带悬吊术治疗中盆腔缺陷为主的脱垂45例临床分析

发布时间：2018-02-09 09:06

本文关键词： 盆腔器官脱垂中盆腔缺陷骶棘韧带悬吊术疗效　出处：《中国妇产科临床杂志》2015年04期 　论文类型：期刊论文

【摘要】：目的探讨骶棘韧带悬吊术治疗以中盆腔缺陷为主的脱垂患者的疗效。方法回顾性分析2011年8月至2014年6月北京大学第一医院妇产科子宫脱垂Ⅲ~Ⅳ期中盆腔缺陷为主行骶棘韧带悬吊术45例盆底脱垂患者的临床资料,并进行随访,评估其疗效及安全性。结果 1 45例患者的平均年龄(55.6±7.2)岁(38~69岁),均成功施行了阴式子宫切除术及骶棘韧带悬吊术,并酌情同时行阴道前后壁修补术和(或)会阴体修补术,手术时间(125±52)min,出血量(108±59)ml,无术中并发症,术后仅一例短暂尿潴留,3例臀部不适,对症处理均好转;2术后随访10~44个月,术后POP-Q分期与术前相比,除阴道总长度(tvl)外,其余各点比较,差异均有统计学意义(P0.05)。术后3个月、6个月、1年、2年POP-Q分期比较,差异均无统计学意义(P0.05)。术后3例出现阴道前壁无症状复发,无顶端复发病例;3术后盆底功能障碍简表-20(pelvic floor distress inventory-short form 20,PFDI-20)评分较术前显著改善(P0.001)。结论骶棘韧带悬吊术治疗中盆腔缺陷为主的脱垂疗效肯定,并发症少,但应注意阴道前壁脱垂复发问题。
[Abstract]:Objective to evaluate the efficacy of sacrospinous ligament suspension in the treatment of prolapse with middle pelvic defects. Methods from August 2011 to June 2014, the pelvic defects of uterus prolapse in obstetrics and gynecology department of the first Hospital of Peking University were analyzed retrospectively. Clinical data of 45 cases of pelvic floor prolapse treated with sacrospinous ligament suspension. Results the average age of 145 patients was 55.6 卤7.2 years old and 3869 years old. All patients were successfully performed vaginal hysterectomy and sacrospinous ligament suspension. The vaginal anterior and posterior wall repair and / or perineum body repair were performed at the same time as appropriate. The operative time was 125 卤52 minutes, the amount of blood loss was 108 卤59ml. There were no complications during the operation, only one case had temporary urinary retention and 3 cases had hip discomfort after operation. All the patients were followed up for 10 ~ 44 months. Compared with preoperative POP-Q staging, there were significant differences in all the other points except the total vaginal length (TVM). The POP-Q staging was compared at 3 months, 6 months, 1 year and 2 years after operation, and there was no significant difference in POP-Q staging between the two groups in 3 months, 6 months, 1 year and 2 years after operation. The difference was not statistically significant (P 0.05). There were 3 cases of asymptomatic recurrence of the anterior wall of vagina after operation. The score of pelvic floor dysfunction was significantly improved in patients without recurrent apical disease (P 0.001) after operation. Conclusion the pelvic defect in the treatment of sacrospinous ligament suspension is more effective than that before operation, and the complications are less. [WT5 "HZ] [WT5" BZ] [WT5BZ] the score of PFDI-20 in patients with pelvic floor dysfunction after operation was significantly improved compared with that before operation (P 0.001). But we should pay attention to the recurrence of prolapse of anterior wall of vagina.
【作者单位】：北京大学第一医院妇产科;甘肃省酒泉市人民医院;
【分类号】：R713

【参考文献】