摘要
目的 探讨经阴道植入网片手术(TVM)联合骶棘韧带固定术(SSLF)对重度盆腔器官脱垂患者生活质量的影响。方法 回顾性分析2018年1月至2021年7月在广州医科大学附属第一医院因重度子宫阴道脱垂接受前路TVM联合SSLF和阴腹联合腹腔镜下阴道骶骨固定术(LSC)患者的病历资料。评估并比较两组患者术后脱垂复发率、阴道网片暴露发生率及盆底功能障碍相关生活质量问卷(PFDI-20、PFIQ-7)评分的差异。结果 研究共纳入202例患者,其中TVM联合SSLF组71例,阴腹联合LSC组131例,中位随访时间为28.5个月,两组基线资料无显著差异(P>0.05)。两组脱垂复发率(4.2%vs. 3.8%)、再次手术率(1.4%vs. 2.3%)、阴道网片暴露率(4.2%vs. 9.1%)相比,差异无统计学意义(P>0.05)。术后PFDI-20、PFIQ-7评分均显著下降,但在阴腹联合LSC组中,术后4例患者出现严重便秘;术后患者满意并同意推荐所行术式的比率分别为76.1%、70.2%,两组相比差异无统计学意义(P>0.05)。结论 TVM联合SSLF能显著改善患者术后生活质量,并具有较高的手术满意度。与阴腹联合LSC相比,TVM联合SSLF可能对术后结直肠症状的影响更小。
Objective To investigate the effects of transvaginal mesh(TVM)combined with sacrospinous ligament fixation(SSLF)on the quality of life in patients with severe pelvic organ prolapse(POP).Methods A retrospective analysis was performed concerning the data of patients who underwent TVM combined with SSLF or the combined transabdominal-transvaginal laparoscopic sacral colpopexy(LSC)due to severe uterine-vaginal prolapse at The First Affiliated Hospital of Guangzhou Medical University from January 2018 to July 2021.Postoperative outcomes including prolapse recurrence rates,incidence of vaginal mesh exposure,and pelvic floor dysfunction-related quality of life(PFDI-20 and PFIQ-7 scores)were evaluated and compared between the two groups.Results A total of 202 patients were included in the study(71 in the TVM combined with SSLF group and 131 in the LSC group),with a median follow-up duration of 28.5 months.No significant differences were observed in the baseline data between the two groups(P>0.05).The prolapse recurrence rate(4.2%vs.3.8%),reoperation rate(1.4%vs.2.3%),and vaginal mesh exposure rate(4.2%vs.9.1%)did not differ significantly between the two groups(P>0.05).Both PFDI-20 and PFIQ-7 scores significantly decreased postoperatively;however,severe constipation occurred in four patients in the LSC group.The rate of postoperative patient satisfaction and willingness to recommend the procedure was 76.1%and 70.2%,respectively;no statistically significant difference was observed between the two groups(P>0.05).Conclusions TVM combined with SSLF significantly improves postoperative quality of life and yields high patient satisfaction,with potentially less impact on postoperative colorectal symptoms compared to LSC.
作者
王苏
张晓薇
陈礼全
徐丽珍
WANG Su;ZHANG Xiao-wei;CHEN Li-quan;XU Li-zhen(Women's Pelvic Floor Specialty,The First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510000,China)
出处
《中国实用妇科与产科杂志》
北大核心
2025年第5期561-564,共4页
Chinese Journal of Practical Gynecology and Obstetrics
基金
广州市卫生健康科技一般引导项目(20221A011076)
广东省医学科学技术研究基金项目(B2024054)。
作者简介
通信作者:张晓薇,电子信箱:xwzhang81341235@163.com。
