腹腔镜下子宫-阴道骶骨固定术联合多部位修复术治疗中重度盆腔器官脱垂37例临床分析

发布时间：2018-06-01 01:21

  本文选题：盆腔器官脱垂 + 尿失禁　； 参考：《中国实用妇科与产科杂志》2015年03期

【摘要】：目的探讨多术式联合治疗盆腔器官脱垂(POP)的疗效、安全性及并发症。方法回顾性分析2007年9月至2012年12月在沈阳市妇婴医院联合应用聚丙烯网片腹腔镜下子宫-阴道骶骨固定术联合改良的阴道旁修补术、圆韧带短缩术、骶韧带缩短术治疗的37例中重度POP患者的临床资料。其中合并糖尿病3例,9例合并宫颈延长(行宫颈部分切除术),合并压力性尿失禁(SUI)9例,合并子宫肌瘤、腺肌病、卵巢囊肿16例(其中2例多发肌瘤、6例单发肌瘤者希望保留子宫,术中同时行肌瘤剔除术;6例行子宫次全切除术;2例卵巢囊肿患者术中行囊肿切除术,术中冰冻病理良性)。既往行子宫次全切除术4例,行子宫全切术1例。患者均有程度不等的性生活不适或性交困难。观察手术时间、术中出血、膀胱功能恢复等,并在术后定期随访,对手术效果进行主客观评价。结果 37例患者盆腔器官脱垂定量系统(POP-Q)分期Ⅱ期10例,Ⅲ期19例,Ⅳ期8例。所有患者经多术式联合治疗均获成功,平均手术时间(153±32)min,平均出血量(185.35±58.40)m L,术后留置尿管(3.0±1.5)d。术后1年复查POP-Q评分较术前明显改善:Aa-2.4±0.5,Ba-2.8±0.4,C-7.5±0.9,Ap-2.5±0.5,Bp-2.6±0.4,相关症状消失或明显改善,无性生活不适及性交痛,无网片侵蚀、暴露、感染等并发症。客观治愈率100%。结论腹腔镜下子宫-阴道骶骨固定术联合多部位修复术治疗盆腔器官脱垂是一种微创、安全、有效的治疗方式。
[Abstract]:Objective to evaluate the efficacy, safety and complications of multi-operation in the treatment of pelvic organ prolapse (POP). Methods from September 2007 to December 2012, the combined application of polypropylene mesh laparoscopy combined with modified paravaginal repair and short contraction of round ligament was performed in Shenyang Hospital for Women and infants. Clinical data of 37 patients with moderate and severe POP treated by sacral ligament shortening. Among them, 9 cases were complicated with diabetes mellitus, 9 cases were complicated by partial cervical excision, 9 cases by stress urinary incontinence, 9 cases by hysteromyoma, and 9 cases by adenomyosis. 16 cases of ovarian cyst (including 2 cases of multiple myoma and 6 cases of single myoma) wanted to preserve the uterus, 6 cases underwent myomectomy and 6 cases underwent subtotal hysterectomy during operation, 2 cases of ovarian cyst underwent cystectomy during operation, and the frozen pathology was benign during operation. Subtotal hysterectomy was performed in 4 cases and hysterectomy in 1 case. Patients have varying degrees of sexual discomfort or difficulty in sexual intercourse. The time of operation, intraoperative bleeding and bladder function recovery were observed. Results in 37 patients with pelvic organ prolapse, there were 10 cases in stage 鈪，

本文编号：1962275