發(fā)布時(shí)間：2018-02-09 09:06

  本文關(guān)鍵詞： 盆腔器官脫垂 中盆腔缺陷 骶棘韌帶懸吊術(shù) 療效　出處：《中國婦產(chǎn)科臨床雜志》2015年04期 　論文類型：期刊論文

【摘要】：目的探討骶棘韌帶懸吊術(shù)治療以中盆腔缺陷為主的脫垂患者的療效。方法回顧性分析2011年8月至2014年6月北京大學(xué)第一醫(yī)院婦產(chǎn)科子宮脫垂Ⅲ~Ⅳ期中盆腔缺陷為主行骶棘韌帶懸吊術(shù)45例盆底脫垂患者的臨床資料,并進(jìn)行隨訪,評(píng)估其療效及安全性。結(jié)果 1 45例患者的平均年齡(55.6±7.2)歲(38~69歲),均成功施行了陰式子宮切除術(shù)及骶棘韌帶懸吊術(shù),并酌情同時(shí)行陰道前后壁修補(bǔ)術(shù)和(或)會(huì)陰體修補(bǔ)術(shù),手術(shù)時(shí)間(125±52)min,出血量(108±59)ml,無術(shù)中并發(fā)癥,術(shù)后僅一例短暫尿潴留,3例臀部不適,對(duì)癥處理均好轉(zhuǎn);2術(shù)后隨訪10~44個(gè)月,術(shù)后POP-Q分期與術(shù)前相比,除陰道總長度(tvl)外,其余各點(diǎn)比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后3個(gè)月、6個(gè)月、1年、2年P(guān)OP-Q分期比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后3例出現(xiàn)陰道前壁無癥狀復(fù)發(fā),無頂端復(fù)發(fā)病例;3術(shù)后盆底功能障礙簡(jiǎn)表-20(pelvic floor distress inventory-short form 20,PFDI-20)評(píng)分較術(shù)前顯著改善(P0.001)。結(jié)論骶棘韌帶懸吊術(shù)治療中盆腔缺陷為主的脫垂療效肯定,并發(fā)癥少,但應(yīng)注意陰道前壁脫垂復(fù)發(fā)問題。
[Abstract]:Objective to evaluate the efficacy of sacrospinous ligament suspension in the treatment of prolapse with middle pelvic defects. Methods from August 2011 to June 2014, the pelvic defects of uterus prolapse in obstetrics and gynecology department of the first Hospital of Peking University were analyzed retrospectively. Clinical data of 45 cases of pelvic floor prolapse treated with sacrospinous ligament suspension. Results the average age of 145 patients was 55.6 鹵7.2 years old and 3869 years old. All patients were successfully performed vaginal hysterectomy and sacrospinous ligament suspension. The vaginal anterior and posterior wall repair and / or perineum body repair were performed at the same time as appropriate. The operative time was 125 鹵52 minutes, the amount of blood loss was 108 鹵59ml. There were no complications during the operation, only one case had temporary urinary retention and 3 cases had hip discomfort after operation. All the patients were followed up for 10 ~ 44 months. Compared with preoperative POP-Q staging, there were significant differences in all the other points except the total vaginal length (TVM). The POP-Q staging was compared at 3 months, 6 months, 1 year and 2 years after operation, and there was no significant difference in POP-Q staging between the two groups in 3 months, 6 months, 1 year and 2 years after operation. The difference was not statistically significant (P 0.05). There were 3 cases of asymptomatic recurrence of the anterior wall of vagina after operation. The score of pelvic floor dysfunction was significantly improved in patients without recurrent apical disease (P 0.001) after operation. Conclusion the pelvic defect in the treatment of sacrospinous ligament suspension is more effective than that before operation, and the complications are less. [WT5 "HZ] [WT5" BZ] [WT5BZ] the score of PFDI-20 in patients with pelvic floor dysfunction after operation was significantly improved compared with that before operation (P 0.001). But we should pay attention to the recurrence of prolapse of anterior wall of vagina.
【作者單位】： 北京大學(xué)第一醫(yī)院婦產(chǎn)科;甘肅省酒泉市人民醫(yī)院;
【分類號(hào)】：R713

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