腹腔镜下阴道骶骨固定术对盆腔脏器脱垂患者围术期指标及性生活质量的影响

Effect of Laparoscopic Vaginal Sacral Fixation on Perioperative Indicators and Sexual Life Quality in Patients with Pelvic Organ Prolapse

目的探究腹腔镜下阴道骶骨固定术在盆腔脏器脱垂患者中的应用效果。方法选取2019年5月—2022年5月本院收治的70例盆腔脏器脱垂患者为研究对象,按随机数字表法分为两组,每组35例。对照组行全盆底重建术,观察组行腹腔镜下阴道骶骨固定术,均随访至术后6个月。对比两组患者的围术期指标、尿动力学、性生活质量及并发症发生情况。结果两组的术中出血量、住院时间比较,组间差异无统计学意义(P>0.05);观察组的手术时间为(103.25±6.97)min,长于对照组的(85.49±3.58)min,尿管留置时间为(2.05±0.48)d,短于对照组的(2.97±0.63)d,组间差异有统计学意义(P<0.05)。术后,观察组的最大尿流率、膀胱顺应性分别为(24.75±2.78)mL/s、(25.48±3.01)mL/cmH_(2)O,均高于对照组的(19.69±2.35)mL/s、(20.31±2.49)mL/cmH_(2)O,残余尿量为(10.34±1.59)mL,少于对照组的(15.65±2.01)mL,组间差异有统计学意义(P<0.05)。女性性功能量表内性唤起、性欲、性高潮、阴道润滑度、疼痛、性生活满意度评分分别为(5.03±0.35)分、(4.84±0.42)分、(4.56±0.39)分、(4.57±0.35)分、(4.95±0.37)分、(4.46±0.35)分,均高于对照组的(4.26±0.41)分、(3.97±0.57)分、(3.78±0.54)分、(3.95±0.23)分、(3.78±0.40)分、(3.87±0.47)分,组间差异有统计学意义(P<0.05)。观察组的并发症发生率为5.71%,低于对照组的22.86%,差异有统计学意义(P<0.05)。结论采用腹腔镜下阴道骶骨固定术治疗盆腔脏器脱垂的效果显著,可改善患者尿动力学指标,提高其性生活质量,且并发症较少,值得临床推广使用。

Objective To investigate the application effect of laparoscopic vaginal sacral fixation in patients with pelvic organ prolapse.Methods 70 patients with pelvic organ prolapse admitted to the hospital from May 2019 to May 2022 were selected as the research objects and were divided into two groups according to random number table method,with 35 cases in each group.The control group underwent total pelvic floor reconstruction,and the observation group underwent laparoscopic vaginal sacral fixation.Both groups were followed up to 6 months after surgery.The perioperative indexes,urodynamics,sexual life quality and complications were compared between the two groups.Results There were no significant differences in intraoperative blood loss and hospital stay between the two groups(P>0.05);the operative time of the observation group was(103.25±6.97)min,which was longer than(85.49±3.58)min of the control group,and the indent time of urinary catheter was(2.05±0.48)d,which was shorter than(2.97±0.63)d of the control group,and the differences between the groups were statistically significant(P<0.05).After surgery,the maximum urine flow rate and bladder compliance in the observation group were(24.75±2.78)mL/s and(25.48±3.01)mL/cmH_(2)O,respectively,which were higher than(19.69±2.35)mL/s and(20.31±2.49)mL/cmH_(2)O in the control group,the residual urine volume was(10.34±1.59)mL,less than(15.65±2.01)mL of the control group,and the differences between the groups were statistically significant(P<0.05).The scores of sexual arousal,sexual desire,orgasm,vaginal lubrication,pain and sexual satisfaction in the female sexual function index of the observation group were(5.03±0.35)points,(4.84±0.42)points,(4.56±0.39)points,(4.57±0.35)points,(4.95±0.37)points and(4.46±0.35)points respectively,which were higher than(4.26±0.41)points,(3.97±0.57)points,(3.78±0.54)points,(3.95±0.23)points,(3.78±0.40)points,(3.87±0.47)points of the control group,and the differences between the groups were statistically significant(P<0.05).The incidence of complications in the observation group was 5.71%,lower than 22.86%in the control group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic vaginal sacral fixation is effective in the treatment of pelvic organ prolapse,which can improve urodynamic indexes and sexual life quality of patients with fewer complications.It is worthy of clinical application.