本文選題：盆腔器官脫垂 + 尿失禁��； 參考：《中國實用婦科與產科雜志》2015年03期

【摘要】：目的探討多術式聯合治療盆腔器官脫垂(POP)的療效、安全性及并發(fā)癥。方法回顧性分析2007年9月至2012年12月在沈陽市婦嬰醫(yī)院聯合應用聚丙烯網片腹腔鏡下子宮-陰道骶骨固定術聯合改良的陰道旁修補術、圓韌帶短縮術、骶韌帶縮短術治療的37例中重度POP患者的臨床資料。其中合并糖尿病3例,9例合并宮頸延長(行宮頸部分切除術),合并壓力性尿失禁(SUI)9例,合并子宮肌瘤、腺肌病、卵巢囊腫16例(其中2例多發(fā)肌瘤、6例單發(fā)肌瘤者希望保留子宮,術中同時行肌瘤剔除術;6例行子宮次全切除術;2例卵巢囊腫患者術中行囊腫切除術,術中冰凍病理良性)。既往行子宮次全切除術4例,行子宮全切術1例。患者均有程度不等的性生活不適或性交困難。觀察手術時間、術中出血、膀胱功能恢復等,并在術后定期隨訪,對手術效果進行主客觀評價。結果 37例患者盆腔器官脫垂定量系統(tǒng)(POP-Q)分期Ⅱ期10例,Ⅲ期19例,Ⅳ期8例。所有患者經多術式聯合治療均獲成功,平均手術時間(153±32)min,平均出血量(185.35±58.40)m L,術后留置尿管(3.0±1.5)d。術后1年復查POP-Q評分較術前明顯改善: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,相關癥狀消失或明顯改善,無性生活不適及性交痛,無網片侵蝕、暴露、感染等并發(fā)癥。客觀治愈率100%。結論腹腔鏡下子宮-陰道骶骨固定術聯合多部位修復術治療盆腔器官脫垂是一種微創(chuàng)、安全、有效的治療方式。
[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，

本文編號：1962275