摘要
目的探讨经阴道骶棘韧带固定术中采用阴道前壁、阴道侧壁、阴道后壁三种入路暴露骶棘韧带的临床应用效果。方法687例子宫脱垂患者均行经阴道骶棘韧带固定术,依据不同的切口入路方法分为阴道前壁组(251例)、阴道侧壁组(228例)和阴道后壁组(208例)。比较三组的手术时间、术中出血量以及术后情况。结果阴道侧壁组手术时间平均(20.2±9.0)min,阴道前壁组平均(39.3±1.0)mm,阴道后壁组平均(36.2±2.0)min。阴道侧壁组的手术时间明显短于另外两组,差异有统计学意义(P<0.05)。阴道侧壁组术中平均出血量为(20.0±8.0)mL,阴道前壁组平均(41.0±2.0)mL,阴道后壁组平均(39.0±2.0)mL。阴道侧壁组的术中出血量明显少于另外两组,差异有统计学意义(P<0.05)。三组的术后疼痛发生率、术后使用抗生素时间、体温升高、肛门排气时间、术后下床活动时间、术后住院时间和术后性生活恢复时间比较,差异均无统计学意义(P>0.05)。三组均无手术并发症发生。结论经阴道骶棘韧带固定术的三种入路疗效肯定、简洁易行,可根据有无尿道膀胱、直肠脱垂,有无阴道壁炎症粘连占位,以及医生手术操作熟练程度、习惯、器械等情况,选择适合的入路。
Objective To explore the clinical effect of exposing sacrospinous ligament through three ways of anterior vaginal wall,lateral vaginal wall and posterior vaginal wall in the fixation of sacrospinous ligament through vagina,and to explore their advantages,disadvantages and applicable scope.Methods All 687 patients with uterine prolapse undenvent transvaginal sacrospinous ligament fixation.According to different incision approaches,they were divided into anterior vaginal wall group(251 cases),lateral vaginal wall group(228 cases)and posterior vaginal wall group(208 cases).The operation time,intraoperative blood loss and postoperative conditions of the three groups were compared.Results The average operation time of the lateral vaginal wall group was(20.2±9.0)min,the anterior vaginal wall group was(39.3±1.0)min,and the posterior vaginal wall group was(36.2±2.0)min.The operation time of the lateral vaginal wall group was significantly shorter than that of the other two groups,with statistical significance(P<0.05).The average intraoperative blood loss was(20.0±8.0)mL in the lateral vaginal wall group,(41.0±2.0)mL in the anterior vaginal wall group,and(39.0±2.0)mL in the posterior vaginal wall group.The intraoperative blood loss in the lateral vaginal wall group was significantly less than that in the other two groups,with statistical significance(P<0.05).There was no statistical significance in the incidence of postoperative pain,postoperative antibiotic use time,elevated body temperature,anal exhaust time,postoperative ambulation time,postoperative hospital stay and postoperative recovery rime of sexual life among the three groups(P>0.05).No surgical complications occurred in the three groups.Conclusion The three approaches of transvaginal sacrospinous ligament fixation have positive efficacy,simple and easy to operate.Suitable approaches can be selected according to whether there is urethral bladder and rectal prolapse,whether there is inflammation and adhesion of vaginal wall,as well as the doctor's surgical proficiency,habits and instruments.
出处
《浙江临床医学》
2021年第10期1491-1492,1495,共3页
Zhejiang Clinical Medical Journal
关键词
经阴道骶棘韧带固定术
切口入路
Transvaginal sacrospinous ligament fixation
Incision approach
作者简介
通信作者:罗义。
