腹腔镜下腹膜外子宫悬吊术加骶韧带缩短术治疗子宫脱垂的疗效观察

发布时间：2018-04-27 03:10

本文选题：腹腔镜 + 腹膜外　；参考：《现代妇产科进展》2015年06期

【摘要】：目的:探讨腹腔镜下腹膜外子宫悬吊术加子宫骶韧带缩短术治疗子宫脱垂的疗效。方法:选取2009年9月至2013年10月在我院实施腹腔镜下腹膜外子宫悬吊术加骶韧带缩短术的60例子宫脱垂患者,评价其手术疗效,并采用PISQ-12评估患者的性生活质量。结果:60例患者腹腔镜子宫悬吊手术时间14~22min,平均(18.4±17.3)min;骶韧带缩短时间为10~19min,平均(12.4±9.3)min;术中出血量10~25ml,平均(11.2±12.1)ml。术中、术后均无并发症发生。随访10~52个月,平均(28.46±9.54)个月。除1例患者12个月后失访,其余59例均未见复发,客观治愈率为100%。与术前比较,术后3、6、12个月的POP-Q各指示点Aa、Ba、C、GH、PB、Ap、Bp、D的位置变化显著,差异均有统计学意义(P0.001)。60例患者的术前PISQ-12总分为(24±6)分。60例患者中,56例术后3个月后有规律性生活,PISQ-12总分为(37±7)分,术后性生活质量较术前明显改善(P0.05)。结论:腹腔镜下腹膜外子宫悬吊术加子宫骶韧带缩短术治疗子宫脱垂创伤小,恢复快,复发率低,不影响性生活质量,值得临床推广应用。
[Abstract]:Objective: to investigate the effect of laparoscopic extraperitoneal uterine suspension combined with uterine sacral ligament shortening in the treatment of uterine prolapse. Methods: from September 2009 to October 2013, 60 patients with uterine prolapse underwent laparoscopic extraperitoneal uterine suspension and sacral ligament shortening in our hospital. The surgical efficacy was evaluated and the sexual life quality of the patients was evaluated by PISQ-12. Results the operative time of laparoscopic uterine suspension in 60 cases was 14 ~ 22 min (mean 18.4 卤17.3 min), sacral ligament shortening time was 10 ~ 19 min (mean 12.4 卤9.3 min), blood loss during operation was 1025 ml (mean 11.2 卤12.1ml). No complications occurred during or after operation. The follow-up was 10 ~ 52 months, with an average of 28.46 卤9.54 months. No recurrence was found in 59 cases except for one patient who lost a visit after 12 months, and the objective cure rate was 100%. There were significant changes in the location of POP-Q indicating sites (AaHN) at 6 and 12 months after operation, and the difference was statistically significant in the total preoperative PISQ-12 scores of 60 patients with P0.001. The total score of preoperative PISQ-12 was 24 卤6. Among the 60 patients, 56 patients had regular life after 3 months and the total score of PISQ-12 was 37 卤7). The quality of sexual life after operation was significantly improved than that before operation (P 0.05). Conclusion: laparoscopic extraperitoneal uterine suspension combined with uterine sacral ligament shortening in the treatment of uterine prolapse has the advantages of small trauma, quick recovery, low recurrence rate and no influence on the quality of sexual life, so it is worth popularizing and applying in clinic.
【作者单位】：临沂市沂水中心医院;
【分类号】：R713.4

【参考文献】