本文關鍵詞： 中盆腔脫垂 子宮骶骨固定術 骶棘韌帶懸吊術 療效　出處：《遵義醫(yī)學院》2017年碩士論文　論文類型：學位論文

【摘要】：目的:比較腹腔鏡下子宮骶骨固定術與經陰道骶棘韌帶懸吊術治療中盆腔脫垂的臨床療效,為中盆腔脫垂患者選擇合理術式提供理論依據。方法:將2014年9月至2015年6月遵義醫(yī)學院附屬醫(yī)院婦科診斷為“中盆腔脫垂”,并接受腹腔鏡下子宮骶骨固定術(L組,15例)或骶棘韌帶懸吊術(S組,15例)治療的有癥狀患者作為研究對象。比較兩組手術、手術時間、術中出血量、手術前后的POP-Q分度、盆腔功能障礙評分問卷(PFDI-20)、盆腔功能影響問卷簡表(PFIQ-7)及盆腔脫垂性生活問卷(PISQ-12)來評估手術療效及生活質量。結果:1.L組手術時間及術中出血量均低于S組(P0.05)。2.兩組術后POP-Q分度較術前均有明顯改善(P0.05),但組間POP-Q分度無差異(P0.05)。3.兩組術后PISQ-12評分均較術前升高(P0.05),L組術后性生活質量評分高于S組(P0.05)。4.兩組術后PFDI-20和PFIQ-7評分均較術前降低(P0.05),但組間均無差異(P均0.05)。5.兩組術后復發(fā)無差異(P0.05)。結論:1.兩種術式均可有效治療中盆腔脫垂,改善患者的生活質量。2.腹腔鏡下子宮骶骨固定組術后患者的性生活質量優(yōu)于骶棘韌帶懸吊組,且該術式具有術野直觀、術中出血量少、住院日短及性生活質量改善明顯等優(yōu)點,但其手術操作復雜。3.有基礎疾病不能耐受全身麻醉的患者可選擇骶棘韌帶懸吊術。
[Abstract]:Objective: to compare the clinical effects of laparoscopic uterine sacral fixation and vaginal sacrospinous ligament suspension in the treatment of pelvic prolapse. Methods: from September 2014 to June 2015, the gynecological department of affiliated hospital of Zunyi Medical College was diagnosed as "middle pelvic prolapse" and underwent laparoscopic hysterectomy and sacrum fixation. Group A (n = 15) or sacrospinous ligament suspension group (n = 15). Operative time, intraoperative bleeding volume, POP-Q score before and after operation, PFDI-20, PFIQ-7 and PISQ-12) were used to evaluate the curative effect and quality of life. Results 1. The operation time and blood loss in group L were lower than those in group S (P0.050.2.). POP-Q scores were significantly improved compared with those before operation (P 0.05), but there was no difference in POP-Q scores between groups. The postoperative PISQ-12 scores in both groups were higher than those in group S (P 0.05). The scores of PFDI-20 and PFIQ-7 in both groups were lower than those before operation (P 0.05), but the scores of PFIQ-7 in group B were lower than those in group A (P 0.05), but the scores of PISQ-12 in group B were lower than those in group S (P < 0.05), but the scores of PFDI-20 and PFIQ-7 in group A were significantly higher than those in group S (P < 0.05). There was no difference between the two groups (P < 0.05). There was no difference in postoperative recurrence between the two groups (P < 0.05). Conclusion the two operative methods are effective in the treatment of pelvic prolapse. To improve the quality of life of the patients. 2. The life quality of the patients in the laparoscopy group was better than that in the sacral ligamentum suspension group, and the operation had the advantages of intuitionistic operation, less intraoperative bleeding, short hospital stay and obvious improvement of sexual life quality. But the operation is complicated. 3. Sacral ligamentum suspension can be selected for patients with underlying diseases who can not tolerate general anesthesia.
【學位授予單位】：遵義醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R713

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