两种术式治疗中盆腔脱垂的临床分析

发布时间：2018-02-22 23:13

本文关键词： 中盆腔脱垂子宫骶骨固定术骶棘韧带悬吊术疗效　出处：《遵义医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:比较腹腔镜下子宫骶骨固定术与经阴道骶棘韧带悬吊术治疗中盆腔脱垂的临床疗效,为中盆腔脱垂患者选择合理术式提供理论依据。方法:将2014年9月至2015年6月遵义医学院附属医院妇科诊断为“中盆腔脱垂”,并接受腹腔镜下子宫骶骨固定术(L组,15例)或骶棘韧带悬吊术(S组,15例)治疗的有症状患者作为研究对象。比较两组手术、手术时间、术中出血量、手术前后的POP-Q分度、盆腔功能障碍评分问卷(PFDI-20)、盆腔功能影响问卷简表(PFIQ-7)及盆腔脱垂性生活问卷(PISQ-12)来评估手术疗效及生活质量。结果:1.L组手术时间及术中出血量均低于S组(P0.05)。2.两组术后POP-Q分度较术前均有明显改善(P0.05),但组间POP-Q分度无差异(P0.05)。3.两组术后PISQ-12评分均较术前升高(P0.05),L组术后性生活质量评分高于S组(P0.05)。4.两组术后PFDI-20和PFIQ-7评分均较术前降低(P0.05),但组间均无差异(P均0.05)。5.两组术后复发无差异(P0.05)。结论:1.两种术式均可有效治疗中盆腔脱垂,改善患者的生活质量。2.腹腔镜下子宫骶骨固定组术后患者的性生活质量优于骶棘韧带悬吊组,且该术式具有术野直观、术中出血量少、住院日短及性生活质量改善明显等优点,但其手术操作复杂。3.有基础疾病不能耐受全身麻醉的患者可选择骶棘韧带悬吊术。
[Abstract]:Objective: to compare the clinical effects of laparoscopic uterine sacral fixation and vaginal sacrospinous ligament suspension in the treatment of pelvic prolapse. Methods: from September 2014 to June 2015, the gynecological department of affiliated hospital of Zunyi Medical College was diagnosed as "middle pelvic prolapse" and underwent laparoscopic hysterectomy and sacrum fixation. Group A (n = 15) or sacrospinous ligament suspension group (n = 15). Operative time, intraoperative bleeding volume, POP-Q score before and after operation, PFDI-20, PFIQ-7 and PISQ-12) were used to evaluate the curative effect and quality of life. Results 1. The operation time and blood loss in group L were lower than those in group S (P0.050.2.). POP-Q scores were significantly improved compared with those before operation (P 0.05), but there was no difference in POP-Q scores between groups. The postoperative PISQ-12 scores in both groups were higher than those in group S (P 0.05). The scores of PFDI-20 and PFIQ-7 in both groups were lower than those before operation (P 0.05), but the scores of PFIQ-7 in group B were lower than those in group A (P 0.05), but the scores of PISQ-12 in group B were lower than those in group S (P < 0.05), but the scores of PFDI-20 and PFIQ-7 in group A were significantly higher than those in group S (P < 0.05). There was no difference between the two groups (P < 0.05). There was no difference in postoperative recurrence between the two groups (P < 0.05). Conclusion the two operative methods are effective in the treatment of pelvic prolapse. To improve the quality of life of the patients. 2. The life quality of the patients in the laparoscopy group was better than that in the sacral ligamentum suspension group, and the operation had the advantages of intuitionistic operation, less intraoperative bleeding, short hospital stay and obvious improvement of sexual life quality. But the operation is complicated. 3. Sacral ligamentum suspension can be selected for patients with underlying diseases who can not tolerate general anesthesia.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R713

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