摘要
目的评价3种骶棘韧带悬吊术式在保留子宫的盆底重建术中的临床效果评价。方法选取2016年1月至2018年6月杭州市第一人民医院妇产科收治的中盆腔脱垂III度及以上患者共98例,其中36例采用经阴道单侧骶棘韧带悬吊(USSLF组),20例经阴道双侧骶棘韧带悬吊(BSSLF组),42例经阴道结合网片的双侧骶棘韧带吊带固定术(MSSLF组),对比三组患者手术时间、术中出血量、术后盆腔器官脱垂定量分期法(POP-Q)指示点、术后盆底功能障碍问卷(PFDI-20)评分、术后复发率及并发症发生情况。结果 3组术中失血、手术时间、住院时间、术后POP-Q指示点Aa、Ba、Ap、Bp比较,差异无统计学意义(F=0.77、1.24、1.76、2.00、1.39、0.67、1.51,均P>0.05)。3组术后C点比较差异有统计学意义(F=5.13,P<0.05),两两比较后,MSSLF组术后C点明显低于USSLF组及BSSLF组。3组术后复发率比较差异有统计学意义(χ~2=6.28,P<0.05),两两比较后,USSLF组复发率较高于MSSLF组及BSSLF组。3组术后PFDI-20评分比较差异有统计学意义(F=9.84,P<0.05),两两比较后,BSSLF组术后PFDI-20评分明显高于其他两组。结论 BSSLF、MSSFL与USSLF均为治疗重度盆腔脱垂的有效手术方式。但USSLF复发率较高,BSSLF对患者的生活质量影响相对较大,而MSSLF复发率最低,远期效果好,对患者生活质量影响相对较小。
Objective To evaluate the clinical effects of three kinds of sacrospinal ligament suspension in uterus-preserving pelvic floor reconstruction.Methods From January 2016 to June 2018,98 patients with pelvic prolapse of degree Ⅲ or above were selected form Hangzhou First People’s Hospital Affiliated to Medical College of Zhejiang University.Among them,36 cases were treated with unilateral sacrospinal ligament suspension(USSLF group),20 cases were treated with bilateral sacrospinal ligament suspension(BSSLF group),and 42 cases were treated with bilateral sacrospinal ligament suspension with mesh(MSSLF group).Finally,we compared the operation time,intraoperative bleeding volume,the indication point of pelvic organ prolapse quantification(POP-Q),the score of pelvic floor distress inventory-short form 20(PFDI-20) and the rate of recurrence and complications among the three groups.Results There were no significant differences in intraoperative blood loss,operative time,length of hospital stay,postoperative POP-Q indicator points including Aa,Ba,Ap and Bp among the three groups(F=0.77,1.24,1.76,2.00,1.39,0.67 and 1.51,respectively,all P>0.05).The difference of postoperative C point among the three groups was statistically significant(F=5.13,P<0.05).After pairwise comparison,the postoperative C point of MSSLF group was significantly lower than that of USSLF group and BSSLF group.In addition,the difference in postoperative recurrence rate among the three groups was statistically significant(χ~2=6.28,P<0.05).After pairwise comparison,the recurrence rate of USSLF group was higher than that of MSSLF group and BSSLF group.And a statistically significant difference also was found in postoperative PFDI-20 scores among the three groups(F=9.84,P<0.05).After pairwise comparison,postoperative PFDI-20 scores of the BSSLF group were significantly higher than those of the other two groups.Conclusion BSSLF,MSSFL and USSLF are all effective surgical methods for severe pelvic prolapse.However,the recurrence rate of USSLF is higher,and BSSLF has a relatively more negative impact on the quality of life of patients,while MSSLF has the lowest recurrence rate,good long-term effect and relatively small impact on the quality of life of patients.
作者
陈丹丹
朱立波
吴少勇
CHEN Dandan;ZHU Libo;WU Shaoyong(Department of Obstetrics and Gynecology,Hangzhou First People's Hospital Affiliated to Medical College of Zhejiang University,Zhejiang Hangzhou 310006,China)
出处
《中国妇幼健康研究》
2019年第11期1456-1459,共4页
Chinese Journal of Woman and Child Health Research
关键词
骶棘韧带悬吊术
子宫脱垂
盆腔器官脱垂
盆底重建
sacrospinal ligament suspension
uterine prolapse
pelvic organ prolapse
pelvic floor reconstruction
作者简介
陈丹丹(1981-),女,主治医师,主要从事妇产科临床研究;通讯作者:吴少勇,主任医师。
