腹腔镜下宫颈腹壁悬吊术与经阴道骶棘韧带悬吊术治疗中重度子宫脱垂的临床分析

发布时间：2018-10-09 16:02

【摘要】：目的:通过对比经腹腔镜下宫颈腹壁悬吊术与经阴道骶棘韧带悬吊术治疗中重度子宫脱垂的疗效,探讨两种手术方式的临床应用。方法:将2015年11月至2016年12月于遵义医学院附属医院妇科诊断为中重度子宫脱垂的30位患者分为腹腔镜下宫颈腹壁悬吊术组(A组,n=15)及经阴道骶棘韧带悬吊术组(B组,n=15)。通过POP-Q分类法测量患者术前、术后各点的距离,以此评估两种术式的治疗效果;以PISQ-12评分表评价术后患者性生活满意度。结果:(1)两组患者术后盆腔器官脱垂分度情况均较术前有明显改善(P0.05),但A组与B组组间对比无差异(P0.05)。(2)A组术中出血量、手术时间、住院天数小于B组(P0.05);术后排气时间、膀胱残余尿量两组无差异(P0.05)。(3)两组术后性生活评分较术前均有提高(P0.05),但A组术后性生活质量评分高于B组(P0.05)。结论:近期而言,腹腔镜下宫颈腹壁悬吊术与经阴道骶棘韧带悬吊术均能有效治疗对中重度子宫脱垂,并能明显改善患者性生活质量。相较于经阴道骶棘韧带悬吊术,腹腔镜下宫颈腹壁悬吊术更微创易学,易于推广。但在缺乏腹腔镜器械条件下及对有心肺功能障碍患者,经阴道骶棘韧带悬吊术不失为一种有益的选择。
[Abstract]:Objective: to compare the efficacy of laparoscopic cervical abdominal wall suspension and vaginal sacrospinous ligament suspension in the treatment of moderate and severe uterine prolapse. Methods: from November 2015 to December 2016, 30 patients diagnosed as moderate or severe uterine prolapse in the affiliated Hospital of Zunyi Medical College were divided into two groups: group A (Group A) and Group B (Group B). POP-Q classification was used to measure the distance between the points before and after operation to evaluate the therapeutic effect of the two methods and the PISQ-12 scale was used to evaluate the patients' satisfaction with sexual life. Results: (1) the pelvic organ prolapse was significantly improved in both groups (P0.05), but there was no significant difference between group A and group B (P0.05). (P0.05) the amount of intraoperative bleeding, operation time, hospital stay in group A were less than those in group B (P0.05), and the time of exhaust after operation was less than that of group B (P0.05), but there was no significant difference between group A and group B (P0.05). There was no difference in bladder residual urine volume between the two groups (P0.05). (3). The score of postoperative sexual life in group A was higher than that in group B (P0.05), but the score of postoperative sexual life in group A was higher than that in group B (P0.05). Conclusion: in the near future, both laparoscopic cervical abdominal wall suspension and vaginal sacrospinous ligament suspension can effectively treat moderate and severe uterine prolapse, and can significantly improve the quality of sexual life of the patients. Compared with vaginal sacrospinous ligament suspension, laparoscopic cervical abdominal wall suspension is more minimally invasive and easy to be popularized. However, in the absence of laparoscopic instruments and in patients with cardiopulmonary dysfunction, vaginal sacral ligamentum suspension is a useful choice.
【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】：R713.4

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