SSLF预防全子宫切除术后阴道顶端脱垂评价

摘要

目的 通过比较因子宫脱垂分别行阴式全子宫切除术和阴式全子宫切除术加骶棘韧带悬吊术(SSLF)两组手术后的效果,评价骶棘韧带悬吊术在预防因子宫脱垂而行阴式全子宫切除术后阴道顶端脱垂的作用.方法 采用病例对照研究方法,比较阴式全子宫切除术组与阴式全子宫切除术加骶棘韧带悬吊术组术后解剖学恢复、主观症状的改善、性生活状况以及骶棘韧带悬吊术中及术后并发症情况.结果 阴式全子宫切除术加骶棘韧带悬吊术组的C点距离(-7.5±0.5)、阴道长度(8.9±1.3)均明显较阴式全子宫切除术组长(-3.1±0.2,3.4±0.8);阴式全子宫切除术加骶棘韧带悬吊术组盆底功能障碍问卷评分(28.6±6.5)较阴式全子宫切除术组显著降低(56.7±8.4),t=23.410,P<0.05;阴式全子宫切除术加骶棘韧带悬吊术组性生活质量问卷评分(97.2±8.9)较阴式全子宫切除术组则显著升高(70.6±9.5),t=12.212,P<0.05.结论 骶棘韧带悬吊术可预防阴式全子宫切除术后的阴道顶端脱垂.%Objective To evaluate the role of sacrospinous ligament fixation ( SSLF ) in preventing vaginal vault prolapse after vaginal hysterectomy ( VH ) due to pelvic organ prolapse by comparing the procedure effects of VH and VH adding SSLF ( VH + SSLF ). Methods Case control study was carried out to compare the anatomic recovery, subjective symptoms amelioration condition and sexual function condition after procedure between VH group and VH + SSLF group, and the complications during SSLF procedure and after it were analyzed. Results C point ( - 7.5 ± 0.5 ) and TVL ( 8.9 ± 1.3 ) in VH ± SSLF group were significantly longer than those ( - 3.1 ± 0.2, 3.4 ± 0.8 ) in VH group. The pelvic floor distress inventory ( PFDI ) score in VH ± SSLF group ( 28.6 ± 6.5 ) was significantly lower than that ( 56.7 ± 8.4 ) in VH group ( t＝ 23. 410, P ＜ 0.05 ), but female sexual function questionnaire ( FSFI ) score in VH ± SSLF group ( 97.2 ± 8.9 ) was significantly higher than that ( 70.6 ± 9.5 ) in VH group ( t＝ 12. 212, P ＜ 0.05 ). Conclusion SSLF procedure can effectively prevent vaginal vault prolapse after VH.