中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2015年
12期
41-43
,共3页
子宫脱垂%腹腔镜阴道骶骨固定术%阴道前后壁膨出%POP-Q评分
子宮脫垂%腹腔鏡陰道骶骨固定術%陰道前後壁膨齣%POP-Q評分
자궁탈수%복강경음도저골고정술%음도전후벽팽출%POP-Q평분
Uterine prolaps%Laparoscopic sacral colpopexy%Vaginal wall prolapse%POP-Q score
目的 探讨腹腔镜阴道骶骨固定术和传统阴式子宫切除联合阴道前后壁修补术治疗中重度子宫脱垂的临床疗效.方法 对2011年3月至2012年3月在郑州大学第一附属医院因中重度子宫脱垂(盆腔器官脱垂定量系统(POP-Q)评价为Ⅱ～Ⅲ度)行盆底修复手术,术后满2年且完成随访的69例患者采用不同术式的临床疗效进行回顾性分析,其中行腹腔镜阴道骶骨固定术29例(观察组),阴式子宫切除联合阴道修补前后壁术40例(对照组),通过主观评价盆底疾病生命质量影响问卷简表(PFIQ-7)和盆底功能障碍性疾病症状问卷简表(PFDI-20)和客观评价(POP-Q)等方法,对围术期及术后各项指标的变化及术后并发症情况进行分析.结果 69例患者随访时间10 ～26个月,平均23个月.术后2年观察组无一例复发,对照组6例阴道前壁轻度膨出,复发率为15％(6/40);8例术后性交困难,发生率为20％(8/40);术后2年客观治愈率观察组为100％(29/29),对照组为85％(34/40);主观满意度观察组为100％ (29/29),对照组为80％ (32/40);PFIQ-7、PFDI-20调查问卷评分及POP-Q评分均较术前明显降低(P＜0.01).结论 腹腔镜阴道骶骨固定术创伤小,术后疼痛等并发症发生率低,术后3个月、6个月、1年、2年随诊无复发、对性生活影响小,所以腹腔镜阴道骶骨固定术是值得临床推广的一种手术方式.
目的 探討腹腔鏡陰道骶骨固定術和傳統陰式子宮切除聯閤陰道前後壁脩補術治療中重度子宮脫垂的臨床療效.方法 對2011年3月至2012年3月在鄭州大學第一附屬醫院因中重度子宮脫垂(盆腔器官脫垂定量繫統(POP-Q)評價為Ⅱ～Ⅲ度)行盆底脩複手術,術後滿2年且完成隨訪的69例患者採用不同術式的臨床療效進行迴顧性分析,其中行腹腔鏡陰道骶骨固定術29例(觀察組),陰式子宮切除聯閤陰道脩補前後壁術40例(對照組),通過主觀評價盆底疾病生命質量影響問捲簡錶(PFIQ-7)和盆底功能障礙性疾病癥狀問捲簡錶(PFDI-20)和客觀評價(POP-Q)等方法,對圍術期及術後各項指標的變化及術後併髮癥情況進行分析.結果 69例患者隨訪時間10 ～26箇月,平均23箇月.術後2年觀察組無一例複髮,對照組6例陰道前壁輕度膨齣,複髮率為15％(6/40);8例術後性交睏難,髮生率為20％(8/40);術後2年客觀治愈率觀察組為100％(29/29),對照組為85％(34/40);主觀滿意度觀察組為100％ (29/29),對照組為80％ (32/40);PFIQ-7、PFDI-20調查問捲評分及POP-Q評分均較術前明顯降低(P＜0.01).結論 腹腔鏡陰道骶骨固定術創傷小,術後疼痛等併髮癥髮生率低,術後3箇月、6箇月、1年、2年隨診無複髮、對性生活影響小,所以腹腔鏡陰道骶骨固定術是值得臨床推廣的一種手術方式.
목적 탐토복강경음도저골고정술화전통음식자궁절제연합음도전후벽수보술치료중중도자궁탈수적림상료효.방법 대2011년3월지2012년3월재정주대학제일부속의원인중중도자궁탈수(분강기관탈수정량계통(POP-Q)평개위Ⅱ～Ⅲ도)행분저수복수술,술후만2년차완성수방적69례환자채용불동술식적림상료효진행회고성분석,기중행복강경음도저골고정술29례(관찰조),음식자궁절제연합음도수보전후벽술40례(대조조),통과주관평개분저질병생명질량영향문권간표(PFIQ-7)화분저공능장애성질병증상문권간표(PFDI-20)화객관평개(POP-Q)등방법,대위술기급술후각항지표적변화급술후병발증정황진행분석.결과 69례환자수방시간10 ～26개월,평균23개월.술후2년관찰조무일례복발,대조조6례음도전벽경도팽출,복발솔위15％(6/40);8례술후성교곤난,발생솔위20％(8/40);술후2년객관치유솔관찰조위100％(29/29),대조조위85％(34/40);주관만의도관찰조위100％ (29/29),대조조위80％ (32/40);PFIQ-7、PFDI-20조사문권평분급POP-Q평분균교술전명현강저(P＜0.01).결론 복강경음도저골고정술창상소,술후동통등병발증발생솔저,술후3개월、6개월、1년、2년수진무복발、대성생활영향소,소이복강경음도저골고정술시치득림상추엄적일충수술방식.
Objective To compare the effects of laparoscopic sacral colpopexy and traditional vaginal hysterectomy combined anterior and posterior vaginal repair on the moderate to severe uterine prolapse patients.Methods From March 2011 to March 2012,69 patients with moderate to severe uterine prolapse (POP quantitation (POP-Q) stage Ⅱ ～ Ⅲ) underwent pelvic reconstruction surgery in the first affiliated hospital of Zhengzhou University,and all of them completed the follow-up in more than 2 years.Twenty patients (observation group) were treated by laparoscopic sacral colpopexy,and 40 patients (control group) were treated by traditional vaginal hysterectomy combined anterior and posterior vaginal repair.Retrospectively analyzed the peri-operative data and outcomes of postoperative courses according to the subjective evaluation(PFIQ-7,PFDI-20) and objective evaluation(POP-Q),as well as applications.Results The patients were followed up for 23 months (10-26 months).After 2-year review,there were no relapse case in observation group,while there were 6 slight bulge of paries anterior vaginase cases in control group,the relapse rate was 15％ (6/40).Eight of them complained about dyspareunia (20％,8/40).The total objective success rate at all vaginal sites was 29 of 29 (100％) in observation group,and 34 of 40(85％) in control group.The subjective satisfaction rate was 29 of 29(100％) in observation group,and 32 of 40(80％) in control group.The mean scores of PFIQ-7 and PFDI-20 were significantly lower than that before the surgery (P ＜ 0.01).Conclusions The laparoscopic sacral colpopexy has minimal wound,less pain and complications.The effect is ideal when followed at 3 months,6 months,1 year and 2 years.It seems that laparoscopic sacral colpopexy is a worthy operation method apllied in the clinics.
