腹腔镜骶骨阴道固定术治疗中盆腔缺陷的疗效
摘要
目的探讨腹腔镜骶骨阴道固定术与传统修补术治疗中盆腔缺陷引起的盆腔脏器脱垂的临床效果差异。方法选取该院2014年1月-2016年12月手术治疗的68例盆腔脏器脱垂患者进行回顾性研究,根据手术方式分为A组(腹腔镜骶骨阴道固定术) 34例、B组(采用传统的修补手术治疗) 34例,对比手术前后两组患者的盆腔器官脱垂定量分度法(POP-Q)分度指示点测定值变化、主观症状改善评分(PGI-C)、盆底生活质量问卷(PFDI-20、PFIQ-7)评分等指标。结果 A组患者的手术时间、术中出血量、肛门排气时间、留置导尿管时间均显著的低于B组(P<0. 05);两组患者的住院时间比较差异无统计学意义(P>0. 05);术前、术后,两组患者的POP-Q分期各指示点(Aa、Ba、C、Ap、Bp)测定值、PFDI-20、PFIQ-7评分组间比较差异均无统计学意义(P>0. 05);术前,两组患者的PISQ-12评分比较,差异无统计学意义(P>0. 05);术后,A组患者的阴道长度(TVL)值、PISQ-12评分大于B组(P<0. 05),A组患者的PGI-C评分显著的低于B组(P<0. 05)。结论腹腔镜骶骨阴道固定术较传统修补术治疗中盆腔缺陷引起的盆腔脏器脱垂具有手术创伤更小、术后恢复更快的优势,同时有利于患者术后性生活质量的进一步改善。
引文
[1]苗娅莉,孙秀丽,杨欣,等.腹腔镜阴道骶骨固定术治疗盆腔器官脱垂的疗效评价[J].实用妇产科杂志,2017,33(2):105-109.
[2]李顺双,纪妹.举宫杯辅助下腹腔镜骶骨阴道固定术与协和式全盆底重建术治疗盆腔器官脱垂的对比研究[J].实用妇产科杂志,2015,31(5):388-391.
[3]Sung VW,Rogers RG,Barber MD,et al.Conceptual framework for patient-important treatment outcomes for pelvic organ prolapse[J].Neurourol Urody,2014,33(4):414-419.
[4]左欣,吴海峰,朱筱娟,等.阴式辅助下腹腔镜骶骨阴道固定术治疗重度盆腔器官脱垂的近期疗效[J].中国微创外科杂志,2016,16(12):1117-1120,1124.
[5]李引弟,雷侠,晋雅凌,等.初产妇产后盆底功能锻炼对盆腔器官脱垂影响的临床研究[J].中国妇幼健康研究,2016,27(11):1384-1387.
[6]刘建和,张劲松,方克伟,等.改良腹腔镜下网片宫颈-骶前韧带固定术治疗子宫颈延长伴子宫脱垂的疗效及安全性[J].中华泌尿外科杂志,2016,37(11):846-850.
[7]Fayyad AM,Siozos CS.Safety and one year outcomes following vaginally assisted laparoscopic uterine sacropexy(VALUES)for advanced uterine prolapse[J].Neurourol Urodyn,2014,33(3):345-349.
[8]Tsikouras P,Dafopoulos A,Vrachnis N,et al.Uterine prolapse in pregnancy:Risk factors,complications and management[J].JMatern Fetal Neonatal Med,2014,27(3):297-302.
[9]范颖,于新平,邢琛,等.腹腔镜阴道骶前固定术19例报告[J].中国微创外科杂志,2015,4(4):301-304.
[10]Aytan H,Tok EC,Ertunc D,et al.The effect of episiotomy on pelvic organ prolapse assessed by pelvic organ prolapse quantification system[J].Eur J Obstet Gynecol Reprod Biol,2014,173(8):34-37.
[11]Rahmanou P,White B,Price N,et al.Laparoscopic hysteropexy:1-to 4-year follow-up of women postoperatively[J].Int Urogynecol J,2014,25(1):131-138.
[12]赵英,鲁永鲜,王文英,等.重度盆腔器官脱垂患者治疗方案选择的相关因素分析[J].中国妇幼健康研究,2016,27(3):354-356.
[13]Yesil N,Watermann D,Farthmann J.Mesh implantation for pelvic organ prolapse improves quality of life[J].Arch Gynecol Obstet,2014,289(4):817-821.
[14]Rahmanou P,Price N,Jackson S,et al.Laparoscopic hysteropexy:A novel technique for uterine preservation surgery[J].Int Urogynecol J,2014,25(1):139-140.
[15]Jeppson PC,Sung VW.Hysterectomy for pelvic organ prolapse:Indications and techniques[J].Clin Obstet Gynecol,2014,57(1):72-82.
[2]李顺双,纪妹.举宫杯辅助下腹腔镜骶骨阴道固定术与协和式全盆底重建术治疗盆腔器官脱垂的对比研究[J].实用妇产科杂志,2015,31(5):388-391.
[3]Sung VW,Rogers RG,Barber MD,et al.Conceptual framework for patient-important treatment outcomes for pelvic organ prolapse[J].Neurourol Urody,2014,33(4):414-419.
[4]左欣,吴海峰,朱筱娟,等.阴式辅助下腹腔镜骶骨阴道固定术治疗重度盆腔器官脱垂的近期疗效[J].中国微创外科杂志,2016,16(12):1117-1120,1124.
[5]李引弟,雷侠,晋雅凌,等.初产妇产后盆底功能锻炼对盆腔器官脱垂影响的临床研究[J].中国妇幼健康研究,2016,27(11):1384-1387.
[6]刘建和,张劲松,方克伟,等.改良腹腔镜下网片宫颈-骶前韧带固定术治疗子宫颈延长伴子宫脱垂的疗效及安全性[J].中华泌尿外科杂志,2016,37(11):846-850.
[7]Fayyad AM,Siozos CS.Safety and one year outcomes following vaginally assisted laparoscopic uterine sacropexy(VALUES)for advanced uterine prolapse[J].Neurourol Urodyn,2014,33(3):345-349.
[8]Tsikouras P,Dafopoulos A,Vrachnis N,et al.Uterine prolapse in pregnancy:Risk factors,complications and management[J].JMatern Fetal Neonatal Med,2014,27(3):297-302.
[9]范颖,于新平,邢琛,等.腹腔镜阴道骶前固定术19例报告[J].中国微创外科杂志,2015,4(4):301-304.
[10]Aytan H,Tok EC,Ertunc D,et al.The effect of episiotomy on pelvic organ prolapse assessed by pelvic organ prolapse quantification system[J].Eur J Obstet Gynecol Reprod Biol,2014,173(8):34-37.
[11]Rahmanou P,White B,Price N,et al.Laparoscopic hysteropexy:1-to 4-year follow-up of women postoperatively[J].Int Urogynecol J,2014,25(1):131-138.
[12]赵英,鲁永鲜,王文英,等.重度盆腔器官脱垂患者治疗方案选择的相关因素分析[J].中国妇幼健康研究,2016,27(3):354-356.
[13]Yesil N,Watermann D,Farthmann J.Mesh implantation for pelvic organ prolapse improves quality of life[J].Arch Gynecol Obstet,2014,289(4):817-821.
[14]Rahmanou P,Price N,Jackson S,et al.Laparoscopic hysteropexy:A novel technique for uterine preservation surgery[J].Int Urogynecol J,2014,25(1):139-140.
[15]Jeppson PC,Sung VW.Hysterectomy for pelvic organ prolapse:Indications and techniques[J].Clin Obstet Gynecol,2014,57(1):72-82.