【摘要】：目的:通過對比經(jīng)腹腔鏡下宮頸腹壁懸吊術(shù)與經(jīng)陰道骶棘韌帶懸吊術(shù)治療中重度子宮脫垂的療效,探討兩種手術(shù)方式的臨床應(yīng)用。方法:將2015年11月至2016年12月于遵義醫(yī)學(xué)院附屬醫(yī)院婦科診斷為中重度子宮脫垂的30位患者分為腹腔鏡下宮頸腹壁懸吊術(shù)組(A組,n=15)及經(jīng)陰道骶棘韌帶懸吊術(shù)組(B組,n=15)。通過POP-Q分類法測量患者術(shù)前、術(shù)后各點的距離,以此評估兩種術(shù)式的治療效果;以PISQ-12評分表評價術(shù)后患者性生活滿意度。結(jié)果:(1)兩組患者術(shù)后盆腔器官脫垂分度情況均較術(shù)前有明顯改善(P0.05),但A組與B組組間對比無差異(P0.05)。(2)A組術(shù)中出血量、手術(shù)時間、住院天數(shù)小于B組(P0.05);術(shù)后排氣時間、膀胱殘余尿量兩組無差異(P0.05)。(3)兩組術(shù)后性生活評分較術(shù)前均有提高(P0.05),但A組術(shù)后性生活質(zhì)量評分高于B組(P0.05)。結(jié)論:近期而言,腹腔鏡下宮頸腹壁懸吊術(shù)與經(jīng)陰道骶棘韌帶懸吊術(shù)均能有效治療對中重度子宮脫垂,并能明顯改善患者性生活質(zhì)量。相較于經(jīng)陰道骶棘韌帶懸吊術(shù),腹腔鏡下宮頸腹壁懸吊術(shù)更微創(chuàng)易學(xué),易于推廣。但在缺乏腹腔鏡器械條件下及對有心肺功能障礙患者,經(jīng)陰道骶棘韌帶懸吊術(shù)不失為一種有益的選擇。
[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.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R713.4

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