全骨盆底悬吊术在女性骨盆底功能重建中的应用

The application of pelvic floor suspension in female pelvic floor reconstruction

目的探讨利用全骨盆底网片悬吊术治疗女性盆腔脏器脱垂并进行骨盆底重建的可行性和有效性。方法对2005年1月至2006年6月确诊为盆腔脏器脱垂的53例患者采用蝶形聚丙烯网片进行经阴道全骨盆底悬吊术，根据临床检查及主诉对手术前后脱垂情况进行评估，观察疗效并定期随访。结果手术时间平均97min，出血量平均160ml，53例均在术后2～6d出院，术后1、3、9、12个月随访，根据国际尿控协会制定的盆腔脏器脱垂定量分度法客观评估子宫脱垂、阴道前后壁膨出等症状全部得到纠正，无复发、无阴道扭曲和缩短、无性生活障碍，满意度达94．3％。结论全骨盆底网片悬吊术是经阴道的微创手术，对盆腔脏器脱垂患者在保留子宫的同时进行骨盆底功能重建，复发率低，值得临床进一步推广。

Objective To explore the feasibility and efficacy of pelvic floor reconstruction surgery for female pelvic organ prolapse（POP） diseases. Methods Transvaginal pelvic floor hammock operations with ＂H＂ shape polypropylene implants were performed on 53 patients with POP from January 2005 to June 2006. All the patients were regularly followed up, and the chief complaints and physical examinations were used as postoperative evaluation criteria. Results Average operating time was 97 min, and average surgical blood loss was 160 ml. After operation, the hospital stay ranged from 2 days to 6 days. Regular follow-up were set at 1, 3, 9, and 12months after operation. Pelvic organ prolapse quantification system was cited to evaluate whether the uterine or/and anterior or/and posterior vaginal prolapses were cured. No recurrence, no vagina distortion, shortening and dyspareunia were observed in all the patients, and satisfaction rate was 94.3%. Conclusions Pelvic floor hammock is a mini-invasive surgery. It can reconstruct the pelvic floor without hystectomy, and recurrent rate is low.