腹腔镜阴道骶骨固定术临床疗效分析与评价(1)
【摘要】 目的：评价与分析腹腔镜阴道骶骨固定术的临床疗效。方法：选取本院2010年1月-2017年1月收治的盆腔脏器脱垂患者50例为对象进行研究，按照随机数字表法分为对照组与观察组，各
25例。对照组术后采用经腹阴道骶骨固定术治疗，观察组术后采用腹腔镜阴道骶骨固定术治疗。比较两组术中出血量、手术时间、术后并发症、术后留置尿管时间、肛门通气时间、住院时间以及随访期间主观满意度、客观治愈率。结果：两组术后住院时间、留置尿管时间、手术时间比较，差异均无统计学意义(P>0.05)。观察组术后肛门排气时间、术中出血量均少于对照组，差异均有统计学意义(P<0.05)。观察组术后并发症发生率为8.0%低于对照组28.0%，差异有统计学意义(P<0.05)。经术后随访6个月，观察组主观满意度、客观治愈率均高于对照组，差异均有统计学意义(P<0.05)。结论：针对盆腔脏器脱垂患者采用腹腔镜阴道骶骨固定术的临床疗效显著，且具有术中出血量少、并发症少、安全可靠等优势，因此值得临床应用推广。
【关键词】 盆腔脏器脱垂； 腹腔镜阴道骶骨固定术； 经腹阴道骶骨固定术治疗
【Abstract】 Objective：To evaluate and analyze the clinical efficacy in laparoscopic sacrocolpopexy(LSC).Method：A total of 50 cases with pelvic organ prolapse(POP)undergoing total hysterectomy in our hospital from January 2010 to January 2017 were divided into control group and observation group according to table of random numbers，25 cases in each group.The control group was treated with transabdominal sacrocolpopexy，and the observation group was treated with LSC.The intraoperative blood loss，operation time，postoperative complications，time of inurethral catheter，anus exhausting time，hospital stay，the subjective satisfaction and objective cure rate during follow-up were compared between the two groups.Result：There were no statistically significant in the operation time，time of inurethral catheter and hospital stay between the two groups(P>0.05).The intraoperative blood loss and anus exhausting time in the observation group were lower than those in the control group，the differences were statistically significant(P<0.05).The rate of postoperative complications in the observation group(8.0%) was lower than that in the control group(28.0%)，the difference was statistically significant(P<0.05).After 6 months follow-up，the subjective satisfaction and objective cure rate in the observation group were higher than those in the control group，the differences were statistically significant(P<0.05).Conclusion：The clinical effect of LSC for patients with POP is significant.It has the advantages of less intraoperative blood loss，fewer complications，and safety and reliability.It is worthy of clinical application.
【Key words】 Pelvic organ prolapse； Laparoscopic sacrocolpopexy； Transabdominal sacrocolpopexy
First-author’s address：Taishan People’s Hospital，Taishan 529200，China
doi：10.3969/j.issn.1674-4985.2018.21.026
在老年女性群體中，盆腔脏器脱垂(pelvic organ prolapse，POP)是一种常见病，尽管其不致命，但对患者的身心健康以及生活质量存在严重影响。患者一旦发病，则会表现为排尿、排便困难、阴道肿物膨出不适等[1-3]。以往改善和修复盆底的术式主要为阴式全子宫切除+阴道前后壁修补术，但其无法达到理想疗效。而目前重建盆底的首选术式为子宫/阴道骶骨固定术，且主要目的在于治疗盆腔缺陷。该术式主要通过在骶骨前纵韧带上固定网片，然后在对筋膜结构以及盆腔肌肉进行有效纠正的基础上，保留阴道深度，并加阴道轴向恢复[4-5]。有关研究表明，腹腔镜阴道骶骨固定术具有创伤小、术野清晰、术后恢复快、盆底解剖恢复好等优势，且能达到74%～98%的远期成功率[6-7]。因此本文即对腹腔镜阴道骶骨固定术的临床疗效进行了评价与分析，现报道如下。, 百拇医药(甄文明 邹岚 伍洁燕)
25例。对照组术后采用经腹阴道骶骨固定术治疗，观察组术后采用腹腔镜阴道骶骨固定术治疗。比较两组术中出血量、手术时间、术后并发症、术后留置尿管时间、肛门通气时间、住院时间以及随访期间主观满意度、客观治愈率。结果：两组术后住院时间、留置尿管时间、手术时间比较，差异均无统计学意义(P>0.05)。观察组术后肛门排气时间、术中出血量均少于对照组，差异均有统计学意义(P<0.05)。观察组术后并发症发生率为8.0%低于对照组28.0%，差异有统计学意义(P<0.05)。经术后随访6个月，观察组主观满意度、客观治愈率均高于对照组，差异均有统计学意义(P<0.05)。结论：针对盆腔脏器脱垂患者采用腹腔镜阴道骶骨固定术的临床疗效显著，且具有术中出血量少、并发症少、安全可靠等优势，因此值得临床应用推广。
【关键词】 盆腔脏器脱垂； 腹腔镜阴道骶骨固定术； 经腹阴道骶骨固定术治疗
【Abstract】 Objective：To evaluate and analyze the clinical efficacy in laparoscopic sacrocolpopexy(LSC).Method：A total of 50 cases with pelvic organ prolapse(POP)undergoing total hysterectomy in our hospital from January 2010 to January 2017 were divided into control group and observation group according to table of random numbers，25 cases in each group.The control group was treated with transabdominal sacrocolpopexy，and the observation group was treated with LSC.The intraoperative blood loss，operation time，postoperative complications，time of inurethral catheter，anus exhausting time，hospital stay，the subjective satisfaction and objective cure rate during follow-up were compared between the two groups.Result：There were no statistically significant in the operation time，time of inurethral catheter and hospital stay between the two groups(P>0.05).The intraoperative blood loss and anus exhausting time in the observation group were lower than those in the control group，the differences were statistically significant(P<0.05).The rate of postoperative complications in the observation group(8.0%) was lower than that in the control group(28.0%)，the difference was statistically significant(P<0.05).After 6 months follow-up，the subjective satisfaction and objective cure rate in the observation group were higher than those in the control group，the differences were statistically significant(P<0.05).Conclusion：The clinical effect of LSC for patients with POP is significant.It has the advantages of less intraoperative blood loss，fewer complications，and safety and reliability.It is worthy of clinical application.
【Key words】 Pelvic organ prolapse； Laparoscopic sacrocolpopexy； Transabdominal sacrocolpopexy
First-author’s address：Taishan People’s Hospital，Taishan 529200，China
doi：10.3969/j.issn.1674-4985.2018.21.026
在老年女性群體中，盆腔脏器脱垂(pelvic organ prolapse，POP)是一种常见病，尽管其不致命，但对患者的身心健康以及生活质量存在严重影响。患者一旦发病，则会表现为排尿、排便困难、阴道肿物膨出不适等[1-3]。以往改善和修复盆底的术式主要为阴式全子宫切除+阴道前后壁修补术，但其无法达到理想疗效。而目前重建盆底的首选术式为子宫/阴道骶骨固定术，且主要目的在于治疗盆腔缺陷。该术式主要通过在骶骨前纵韧带上固定网片，然后在对筋膜结构以及盆腔肌肉进行有效纠正的基础上，保留阴道深度，并加阴道轴向恢复[4-5]。有关研究表明，腹腔镜阴道骶骨固定术具有创伤小、术野清晰、术后恢复快、盆底解剖恢复好等优势，且能达到74%～98%的远期成功率[6-7]。因此本文即对腹腔镜阴道骶骨固定术的临床疗效进行了评价与分析，现报道如下。, 百拇医药(甄文明 邹岚 伍洁燕)