[1]彭荣芳,林　芳,钟爱群,等.保留子宫的腹腔镜后路骶棘韧带悬吊术治疗中重度中盆腔缺陷疗效观察[J].新乡医学院学报,2020,37(2):156-160.[doi:10.7683/xxyxyxb.2020.02.013]
　PENG Rongfang,LIN Fang,ZHONG Aiqun,et al.Effect of laparoscopic posterior approach sacrospinous ligament suspension with preservation of uterus in the treatment of moderate and severe mid pelvic defects[J].Journal of Xinxiang Medical University,2020,37(2):156-160.[doi:10.7683/xxyxyxb.2020.02.013]
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保留子宫的腹腔镜后路骶棘韧带悬吊术治疗中重度中盆腔缺陷疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年2
页码:
156-160
栏目:
临床研究
出版日期:
2020-02-05

文章信息/Info

Title:
Effect of laparoscopic posterior approach sacrospinous ligament suspension with preservation of uterus in the treatment of moderate and severe mid pelvic defects
作者:
彭荣芳; 林　芳; 钟爱群; 秦　炜; 曾　荔
（佛山市高明区人民医院妇产科，广东　佛山　528500）
Author(s):
PENG Rongfang; LIN Fang; ZHONG Aiqun; QIN Wei; ZENG Li
(Department of Gynecology and Obstetrics,the People′s Hospital of Gaoming District of Foshan City,Foshan 528500,Guangdong Province,China)
关键词:
腹腔镜手术; 中盆腔缺陷; 骶棘韧带固定术; 阴道骶骨固定术
Keywords:
laparoscopic surgery; mid pelvic defect; sacrospinous ligament suspension; vaginal sacrum fixation
分类号:
R711
DOI:
10.7683/xxyxyxb.2020.02.013
文献标志码:
A
摘要:
目的　探讨保留子宫的腹腔镜后路骶棘韧带悬吊术（LPASLS）治疗中重度中盆腔缺陷患者的临床效果。方法　选择2016年5月至2018年8月佛山市高明区人民医院收治的31例中重度中盆腔缺陷女性患者为研究对象，根据手术方式分为观察组（n=13）和对照组（n=18）；观察组患者行保留子宫的LPASLS，对照组患者行保留子宫的腹腔镜阴道骶骨固定术，比较2组患者的手术时间、术中出血量、肛门排气时间、留置尿管时间、平均住院时间；术后随访1 a，根据盆腔器官脱垂定量评价系统（POP-Q）评估方法观测Aa、Ba、Ap、Bp、C、D等6个指示点相对于处女膜缘的位置，对脱垂情况进行量化，根据POP-Q分度标准评估术后客观疗效；采用患者总体印象评分（PGI-C）、盆底生活质量问卷（PFDI-20）和性生活质量问卷（PISQ-12）评估术后主观满意度。结果　观察组患者手术时间、术中出血量均显著低于对照组（P＜0.05），2组患者肛门排气时间、留置尿管时间和住院时间比较差异无统计学意义（P＞0.05）。2组患者术前、术后的Aa、Ba、Ap、Bp、C、D指示点测量值及PFDI-20、PISQ-12评分比较差异均无统计学意义（P＞0.05）；与术前比较，2组患者术后1 a的Aa、Ba、Ap、Bp、C、D指示点测量值及PFDI-20评分显著降低（P＜0.05），PISQ-12评分均显著增高（P＜0.05）。术后1 a，2组患者的PGI-C评分比较差异无统计学意义（P>0.05）。结论　保留子宫的LPASLS与保留子宫的腹腔镜阴道骶骨固定术治疗中重度中盆腔缺陷的疗效相当，但保留子宫的LPASLS手术时间明显缩短，术中出血量明显减少。
Abstract:
Objective　To investigate the clinical effect of laparoscopic posterior sacrospinous ligament suspension (LPASLS) for the treatment of patients with moderate to severe mid pelvic defects.Methods　Thirty-one female patients with moderate to severe mid pelvic defects who admitted to the People′s Hospital of Gaoming District of Foshan City from May 2016 to August 2018 were selected as observation objects.All patients were divided into observation group (n=13) and control group (n=18) according to the operation method.The patients in the observation group received uterus-preserving LPASLS,and the patients in the control group received uterus-preserving laparoscopic vaginal sacral fixation.The operation time,intraoperative bleeding volume,anal exhaust time,indwelling catheter time,and average hospitalization time were compared between the two groups.All patients were followed-up for 1 year.The position of 6 indicator points (Aa,Ba,Ap,Bp,C,D) relative to the hymen edge were observed according to the pelvic organ prolapse quantitative evaluation system (POP-Q) evaluation method and the prolapse was quantified.The efficacy was evaluated according to the POP-Q indexing standard.The subjective satisfaction was assessed by the patient′s overall impression score (PGI-C),pelvic floor quality of life questionnaire (PFDI-20),and sexual quality of life questionnaire (PISQ-12).Results　The operation time and intraoperative bleeding volume of patients in the observation group were significantly lower than those in the control group (P<0.05).There was no significant difference in the anal exhaust time,indwelling catheter time and average hospitalization time between the two groups (P>0.05).There was no significant difference in the measured values of Aa,Ba,Ap,Bp,C,and D points and PFDI-20 and PISQ-12 scores of patients between the two groups before and after surgery (P>0.05).The measured values of Aa,Ba,Ap,Bp,C,and D points and PFDI-20 scores of patients at one year after operation were significantly lower than those before operation,but the PISQ-12 score was significantly higher than that before operation in the two groups (P<0.05).There was no significant difference in the PGI-C scores between the two groups at one year after operation (P>0.05).Conclusions　Uterus-preserving LPASLS is equivalent to uterine-preserving laparoscopic vaginal sacral fixation in the treatment of moderate to severe mid pelvic defects,but uterine-preserving LPASLS has shorter operation time and less bleeding volume.

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更新日期/Last Update: 2020-02-05