改良盆底加固法在非脱垂阴式子宫切除的应用

Application of improved pelvic floor prolapse strengthening in transvaginal hysterectomy(TVH)

目的探讨改良盆底加固法防治非脱垂阴式子宫切除术后并发症的临床效果。方法选择近两年来在该院行非脱垂阴式子宫切除术患者80例,按随机表法随机分为改良盆底加固法+非脱垂阴式子宫切除术40例(设为研究组)和单纯非脱垂阴式子宫切除术40例(设为对照组),进行两组临床效果的对比分析。结果①术后阴道长度:研究组(85.12±4.80)mm、对照组(65.22±4.12)mm,差异有显著性(P<0.01);②术后阴道少量出血持续时间:研究组(15.11±2.45)d、对照组(24.15±3.45)d,差异有显著性(P<0.01);③阴道分泌物增多持续时间:研究组(20.15±3.55)d、对照组(30.14±5.75)d,差异有显著性(P<0.01);④残端息肉发生率:研究组5%、对照组22.50%,差异有显著性(P<0.05);⑤术后阴道炎发生率:研究组5%、对照组20%,差异有显著性(P<0.05);⑥阴道残端脱垂率:研究组5%、对照组25%,差异有显著性(P<0.01);⑦下腹部或腰骶部坠胀感发生率:研究组10%、对照组30%,差异有显著性(P<0.05);⑧术后性生活满意度评分:6个月研究组(6.68±0.80)分[配偶(7.10±0.51)分]、对照组(4.51±0.51)分[配偶(4.55±0.52)分],12个月研究组(6.98±0.81)分[配偶(7.11±0.13)分]、对照组(4.55±0.60)分[配偶(4.75±0.60)分],差异有显著性(P<0.01)。结论改良盆底加固法在非脱垂阴式子宫切除术中可起到保持盆底支持组织的完整性,降低术后并发症,明显提高阴式子宫切除术后妇女生活质量的作用。

【Objectives】To explore the clinical efficacy of the floor prolapse strengthening in complications prophylation.【Methods】80 cases of non-prolapse hysterectomy in recent years were randomly divided into 40 cases of improved pelvic floor prolapse strengthening＋non-prolapse TVH group,simply prolapse TVH 40 cases for hysterectomy group,two groups of comparative analysis of clinical effects.【Results】①Postoperative vaginal length： study group （85.12±4.80）mm,the control group （ 65.22±4.12）mm,the difference was significant （P 0.01）;②duration of postoperative vaginal bleeding： study group （15.11±2.45）d,control group （24.15±3.45）d,the difference was significant （P 0.01）;③increased vaginal discharge duration： The study group （20.15±3.55）d,control group （30.14±5.75）d,the difference was significant （P 0.01）;④stump the incidence of polyps： study group 5%,22.50% in control group,the difference was statistically significant （P 0.05）;⑤postoperative incidence of vaginitis： study group 5%,20% of the control group,the difference was statistically significant （P 0.05）;⑥vaginal stump prolapse rate： 5% of study group,25% of the control group,the difference was statistically significant （P 0.01）;⑦heavy feeling in the lower abdomen or lumbosacral rate： 10% of study group,30% of the control group,the difference was statistically significant（P 0.05）;⑧postoperative sexual satisfaction score： 6 m research group（6.68±0.80） points [husband （7.10±0.51） points],control group （4.51±0.51） points [husband （4.55±0.52） points],12 m study group（6.98±0.81） points [（husband （7.11±0.13） points],control group（4.55±0.60） points [husband （4.75±0.60） points],the difference was statistically significant （P 0.01）.【Conclusion】The modified reinforcement of pelvic floor prolapse in non-vaginal hysterectomy can maintain the integrity of pelvic floor supporting tissues,reduce complications,vaginal hysterectomy significantly improve the quality of life of women.