经阴道坐骨棘筋膜固定术治疗盆腔器官脱垂的临床疗效研究
Clinical efficacy study of transvaginal ischia spinous fascia fixation in the treatment of pelvic organ prolapse
何为 1仇雅晨 1杨颖 1王青元 1邹俊驰 1王文艳1
作者信息
- 1. 安徽医科大学第二附属医院妇产科,合肥 230601
- 折叠
摘要
目的 探讨经阴道坐骨棘筋膜固定术治疗盆腔器官脱垂的安全性和有效性.方法 回顾性分析124例因Ⅲ-Ⅳ度盆腔器官脱垂接受手术治疗的患者,其中53例行经阴道坐骨棘筋膜固定术(ISFF)作为研究组(ISFF组),71例行经阴道骶棘韧带固定术(SSLF)作为对照组(SSLF组).比较两组患者手术时间、术后住院时间、术前术后血红蛋白值、尿管留置时间、术后疼痛评分、住院费用以及并发症发生情况,采用盆腔器官脱垂分期法(POP-Q)客观评价手术疗效,采用盆底障碍影响简易问卷-7(PFIQ-7)、盆底功能障碍问卷20(PFDI-20)和性生活质量问卷12(PISQ-12)得分评价患者术后生活质量.结果 ISFF组患者手术时间及术后住院时间少于SSLF组,差异有统计学意义(P<0.05).两组患者术前术后血红蛋白值、尿管留置时间、术后疼痛评分、住院费用比较,差异无统计学意义.术后3个月随访,两组客观成功率均为100％.两组患者中位随访时间24个月(12～41个月),ISFF组复发2例,复发率为3.77％,主观满意度为96.23％,SSLF组复发3例,失访2例,复发率4.34％,主观满意度为95.65％.SSLF组1例患者术后出现直径约5 cm盆腔血肿,予以止血等对症处理后血肿消失.两组均无脏器损伤及输血的患者.结论 经阴道坐骨棘筋膜固定术是安全有效的治疗盆腔器官脱垂的术式,并且具有手术时间短、术后恢复快、并发症少、能改善患者生活质量等优点.
Abstract
Objective To explore the safety and effectiveness of transvaginal ischia spinous fascia fixation for pelvic organ prolapse.Methods The retrospective analysis of 124 patients who underwent surgical treatment for stage Ⅲ-Ⅳ pelvic organ prolapse was conducted.Among them, 53 cases of transvaginal ischia spinous fascia fixation (IS-FF) were performed as a study group (ISFF group) while 71 cases of transvaginal sacrospinous ligament fixation (SSLF) were performed as a control group (SSLF group) .The operation time, postoperative hospitalization days, preoperative and postoperative hemoglobin values, indwelling urinary catheter time, postoperative pain scores, and the occurrence of complications were compared between the two groups, and the efficacy of the operation was objec-tively evaluated by using the staging method of pelvic organ prolapse (POP-Q) .Also the scores of the pelvic floor impact questionnaire-7 (PFIQ-7) , the pelvic floor dysfunction questionnaire-20 (PFDI-20) , and the questionnaire of quality of life12 (PISQ-12) were used to evaluate the patients' postoperative quality of life.Results The oper-ation time and postoperative hospitalization days of patients in the ISFF group were less than those in the SSLF group , and the differences were statistically significant (P<0.05) .The preoperative and postoperative hemoglobin values, retention time of urinary catheter, postoperative pain scores, and hospitalization costs of patients in the two groups were compared, and the differences were not statistically significant.At the 3-month postoperative outpatient follow-up, the objective success rate was 100％ in two groups.The median follow-up time of patients in both groups was 24 months (12-41 months) , and there were 2 cases of recurrence in the ISFF group, with a recurrence rate of 3.77％ and a subjective success rate of 96.23％.While there were 3 cases of recurrence in the SSLF group and 2 cases of loss of visit, with a recurrence rate of 4.34％ and a subjective success rate of 95.65％.1 patient in the SSLF group presented with a pelvic hematoma with a diameter of about 5 cm after surgery.The hematoma disap-peared after hemostasis and other symptomatic treatment.There was no organ injury or blood transfusion in both groups.Conclusion Transvaginal ischia spinous fascia fixation is a safe and effective treatment for pelvic organ prolapse, and it has the advantages of short operation time, fast postoperative recovery, fewer complications, and improvement of patients' quality of life.
关键词
坐骨棘筋膜固定术/骶棘韧带固定术/盆腔器官脱垂/脱垂生活质量问卷/妇科外科手术Key words
ischia spinous fascia fixation/sacrospinous ligament fixation/pelvic organ prolapse/prolapse quality of life questionnaire/gynecologic surgical procedures引用本文复制引用
基金项目
国家自然科学基金(81100412)
安徽省自然科学基金(2008085MH283)
出版年
2024
国家科技期刊平台
NSTL
万方数据