摘要
目的探讨改良腹腔镜子宫骶骨固定术治疗前中盆腔器官脱垂的疗效。方法回顾性分析2020年9月至2023年7月因前中盆腔器官脱垂在我院行改良腹腔镜子宫骶骨固定术的30例患者的临床资料。观察患者围术期相关指标、随访期间并发症等,比较患者手术前后盆腔器官脱垂定量分期法(POP-Q)评分、盆底功能障碍问卷简表20(PFDI-20)评分、盆底功能影响问卷简表7(PFIQ-7)评分、患者全身状况改善问卷(PGI-I)评分等。结果所有患者手术均顺利完成,无中转开腹及严重并发症。手术时间平均(170.8±21.5)min,术中出血量平均(29.3±20.2)mL,术后排气时间平均(1.7±0.7)d,术后留置尿管时间平均(2.3±0.6)d,术后住院时间平均(4.2±0.8)d。除阴道总长度外,术后3、6个月患者POP-Q其他指示点较术前明显改善(P<0.05);患者术后6个月PFDI-20评分、PFIQ-7评分均较术前明显改善(P<0.05)。患者客观治愈率100%;PGI-I问卷结果显示,患者主观成功率100%。结论改良腹腔镜子宫骶骨固定术是治疗前中盆腔器官脱垂的有效术式,具有解剖恢复好、满意度高、术后并发症少等优点,且短期疗效确切。
Objective To analyze the outcome of modified laparoscopic uterosacral fixation in the treatment of anterior and middle pelvic organ prolapse.Methods The clinical data of 30 patients with anterior and middle pelvic organ prolapse undergoing modified laparoscopic uterosacral fixation in our hospital from September 2020 to July 2023 were analyzed retrospectively.The perioperative related indicators and complications of patients during follow-up were observed.The pelvic organ prolapse quantification(POP-Q)scores,pelvic floor distress inventory-short form 20(PFDI-20)scores,pelvic floor impact questionnaire-short form 7(PFIQ-7)scores,and patient global impression of improvement(PGI-I)scores of patients before and after operation were compared.Results The operations of all patients were successfully completed without conversion to open surgery or serious complications.The average operation time was(170.8±21.5)minutes,the average intraoperative blood loss was(29.3±20.2)mL,the average postoperative exhaust time was(1.7±0.7)days,the average postoperative retaining urinal catheter time was(2.3±0.6)days,and the average postoperative hospitalization time was(4.2±0.8)days.Except for the total vaginal length,other indicators of POP-Q of patients 3 and 6 months after operation were significantly improved compared with those before operation(P<0.05).The PFDI-20 score and PFIQ-7 score of patients 6 months after operation were significantly improved compared with those before operation(P<0.05).The objective cure rate of patients was 100%;the results of PGI-I questionnaire showed that the subjective success rate of patients was 100%.Conclusion Modified laparoscopic uterosacral fixation is an effective operation for the treatment of anterior and middle pelvic organ prolapse,which has the advantages of good anatomical recovery,high satisfaction,and few postoperative complications,with a definite short-term curative effect.
作者
梁柳婵
秦俞红
陆卉
陈坤
LIANG Liu-chan;QIN Yu-hong;LU Hui;CHEN Kun(Department of Obstetrics and Gynecology,Liuzhou Municipal Liutie Central Hospital,Liuzhou Guangxi 545007,China)
出处
《局解手术学杂志》
2025年第8期706-710,共5页
Journal of Regional Anatomy and Operative Surgery
基金
广西壮族自治区卫生健康委员会自筹经费科研项目(Z20210971)。
关键词
盆腔器官脱垂
腹腔镜手术
改良骶骨固定术
聚丙烯网片
pelvic organ prolapse
laparoscopic surgery
modified uterosacral fixation
polypropylene mesh
作者简介
通信作者:陈坤,E-mail:20755375@qq.com。
