经阴道骶棘韧带悬吊治疗盆腔器官脱垂的疗效观察

【目的】探讨经阴道骶棘韧带悬吊治疗盆腔器官脱垂(POP)的临床疗效。【方法】选取2016年1月至2018年11月在本院治疗的POP患者47例,根据选取的手术方案分为观察组(n=27)和对照组(n=20),观察组给予阴道骶棘韦刃带悬吊术,对照组给予骨盆漏斗韧带悬吊术,比较两组患者手术时间、术中出血量等;所有患者均于术后3个月进行POP-Q测量,其中Ba指阴道前壁中线距处女膜缘3cm处,C指阴道残端和Bp指阴道穹窿的反摺及阴道残端距阴道处女膜中线点最远处。术后1年采用盆底功能障碍问卷-20(PFDI-20)和性生活问卷-12(PISQ-12)评估两组患者生活质量和性生活质量并比较。【结果】观察组手术时间、术中出血量和留置尿管时间分别为(64.02±13.22)min、(87.20±12.23)mL和(87.92±12.21)h,明显少于对照组(P<0.05);观察组和对照组术后3个月Ba、C和Bp较术前改善(P<0.05),但两组术后3个月Ba、C和Bp比较差异无统计学意义(P>0.05);观察组术后1年PDFI-20评分为(20.03±2.19)分,明显低于对照组(P<0.05),而PISQ-12评分为(43.30±5.10)分,明显高于对照组(P<0.05);两组术后并发症发生率比较差异无统计学意义(P>0.05);两组随访期间无复发病例发生。【结论】经阴道骶棘韧带悬吊术治疗POP疗效显著,减少手术时间和术中出血量,提高患者生活及性生活质量,值得临床推广应用。

Effect of Transvaginal Sacrospinous Ligament Suspension on Pelvic Organ Prolapse

【Objeetive】To investigate the clinical effect of transvaginal sacrospinous ligament suspension and pelvic funnel ligament suspension in treatment of pelvic organ prolapse.【Methods】A total of 47 patients with pelvic organ prolapse(POP)treated in our hospital from January 2016 to November 2018 were selected and divided into the observation group(n=27)and the control group(n=20)according to the selected surgical scheme.Patients in the observation group were treated with vaginal sacrospinous ligament suspension,while patients in the control group were treated with pelvic funnel ligament suspension.The operation time and bleeding volume were recorded.All patients underwent POP-Q measurement at 3 months after operation.In the measurement.Bn referred to the anterior wall of the vagina at a distance of 3 cm from the edge of the hymen.C referred to the stump of the vagina and Bp referred to the reflex of the vaginal fornix and the stump of the vagina to the tnidline of the vaginal hymen.The pelvic floor dysfunction queslioimairc-20(PFD1-20)and the pelvic organ prolapse/uri nary incontinence sexual questionnaire-12(PISQ-12)were used to evaluate the quality of life and sexual life of patients.【Results】The operation time,intraoperative bleeding volume and indwelling time of urinary catheter in the observation group were(64.02±13.22)min.(87.20±12.23)ml and(87.92±12.21)h.irrespectively,which were significantly shorter than those in the control group(P<0.05).Ba,C,and Bp in the observation group and the control group were improved at 3 months after surgery(P<0.05).however,there was no significant difference in Ba,C,and Bp at 3 months after surgery in the two groups(P>0.05).One year after operation,the PDFI-20 score of the observation group was(20.03±2.19),which was significantly lower than that of the control group(P<0.05);while the PISQ 12 score was(43.30±5.10),which was signif icantly higher than that of the control group(P<0.05).There was no significant difference in the incidence of complications between the observation group and the control group(P>0.05);No recurrence occurred during the follow-up period in the observation group and the control group.【Conclusion】Iransvaginal sacrospinous ligament suspension has significant curative effect on pelvic organ prolapse.It can reduce the operation time and the amount of intraoperative bleeding,and improve the quality of patients lives and sexual life,which is worthy of clinical promotion and application.