新式腹腔镜下子宫腹壁悬吊术治疗子宫脱垂的临床效果观察

摘要

Objective To investigate the curative effect of laparoscopic uterine abdominal wall suspension on the treatment of patients with moderate and severe pelvic organ prolapse.Methods Totally 23 cases with moderate and severe pelvic organ prolapse were treated with laparoscopic uterine abdominal wall suspension.According to the internationally recognized pelvic organ prolapse (POP-Q),the values of POP-Q before and after treatment were compared.The quality of life of PFDI-20,POPDI-6,CARDI-8,UDI-6 and PISQ-31 scores (SAS) and the sleep status self-rating scale (SRSS) were used to compare the mental status of the patients before and after the operation (P ＜ 0.01).Results After treatment (except vaginal length),scores of POP-Q were significantly better than those before treatment (P ＜ 0.01).After six months of follow-up,PFDI-20,POPDI-6,CARDI-8,UDI-6 score significantly decreased,while PISQ-31 scores increased significantly (P ＜ 0.01).The incidence rate of postoperative complications was significantly lower than that before operation (P ＜0.01).Postoperative SAS score and SRSS score significantly decreased (P ＜ 0.01).Conclusion For patients with moderate and severe pelvic organ prolapse,the laparoscopic uterine abdominal wall suspension can effectively ensure the integrity of the pelvic floor structure and improve the quality of life of patients.%目的 探讨腹腔镜下子宫腹壁悬吊术治疗中重度中盆腔器官脱垂的疗效.方法 将23例中重度中盆腔器官脱垂患者作为研究对象,采用腹腔镜下子宫腹壁悬吊术开展治疗,随后依据国际公认的盆腔器官脱垂量化分级法(POP-Q)比较患者POP-Q各点数值在治疗前后变化及随访后半年患者的生活质量问卷PFDI-20、POPDI-6、CARDI-8、UDI-6、PISQ-31得分数值分布;对比患者手术前后并发症发生率,采用焦虑自评量表(SAS)评分、睡眠状态自评量表(SRSS)评分比较患者手术前后精神状况.结果 患者治疗后(除阴道全长),POP-Q各项数据显著优于治疗前(P＜0.01);随访半年后,PFDI-20、POPDI-6、CARDI-8、UDI-6得分较治疗前均显著减少,PISQ-31评分显著增高(P＜0.01);术后并发症发生率较术前显著降低(p＜0.01);术后患者SAS评分及SRSS评分较术前显著降低(P＜0.01).结论 行腹腔镜下子宫腹壁悬吊术治疗中重度盆腔器官脱垂患者,手术简单,能够有效保证患者盆底结构完整,提高患者生活质量.