举宫杯辅助下腹腔镜骶骨阴道固定术与协和式全盆底重建术治疗盆腔器官脱垂的对比研究

发布时间：2018-04-09 01:37

本文选题：盆腔器官脱垂　切入点：举宫杯　出处：《实用妇产科杂志》2015年05期

【摘要】：目的:比较举宫杯辅助下腹腔镜骶骨阴道固定术(CALS)与协和式全盆底重建术在治疗盆腔器官脱垂的临床疗效。方法:回顾性分析2011年1月至2013年5月于郑州大学第一附属医院行CALS 26例(CALS组)与同期行协和式全盆底重建术的43例患者(小网片组)的临床资料,包括一般情况、围手术期情况、POP-Q指示点数值、复发率、网片侵蚀率。结果:除术中出血量CALS组(29.8±22.2 ml)较小网片组(156.5±61.8 ml)明显减少外(P0.01),手术时间、术后保留尿管时间、住院天数两组差异无统计学意义(P0.05)。两组自身POP-Q各指示点除阴道全长(TVL)外,其余各指示点数值术前、术后差异均有统计学意义(P0.01);两组术前POP-Q各指示点数值差异无统计学意义(P0.05);两组术后各指示点数值相比,仅C点、TVL差异有统计学意义(P0.05)。CALS组和小网片组比较术后1年的复发率、侵蚀率,差异均有统计学意义(P0.05)。结论:CALS和协和式全盆底重建术均能恢复盆腔解剖结构,而CALS术后复发率及网片侵蚀率低,是一种更安全、有效的治疗盆腔器官脱垂的手术方式。
[Abstract]:Objective: to compare the clinical effect of laparoscopic sacral vagina fixation (CALS) with consonant total pelvic floor reconstruction in the treatment of pelvic organ prolapse.Methods: the clinical data of 26 patients with CALS and 43 patients with concomitant total pelvic floor reconstruction from January 2011 to May 2013 in the first affiliated Hospital of Zhengzhou University were analyzed retrospectively, including general situation.During the perioperative period, POP-Q indicator value, recurrence rate and net erosion rate were measured.Results: the intraoperative bleeding volume in CALS group was 29.8 卤22.2 ml, which was significantly lower than that in the small mesh group (156.5 卤61.8 ml). There was no significant difference between the two groups in the time of operation, the time of retention of urinary catheter after operation, and the length of stay in hospital.There were statistically significant differences between the two groups in the values of each indicator point of POP-Q before operation except for the total length of vagina (TVLV), there was no significant difference in the values of each indicator point of POP-Q between the two groups before operation (P 0.05), and there was no significant difference between the two groups in the value of each indicator point after operation (P 0.05), and there was no significant difference between the two groups (P 0.05).There were significant differences in the recurrence rate and erosion rate between the two groups (P 0.05) and the small mesh group (P 0.05).Conclusion both of them can restore the anatomical structure of the pelvic cavity, while the recurrence rate and the erosion rate of the mesh are low after CALS, which is a more safe and effective method for the treatment of pelvic organ prolapse.
【作者单位】：郑州大学第一附属医院;
【基金】：河南省科技攻关计划项目(编号:112102310105)
【分类号】：R713

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