应用腹腔镜子宫骶骨固定术治疗盆底障碍性疾病

The Application of Laparoscopic Uterine Sacral Fixation in the Treatment of Pelvic Floor Dysfunction

目的探讨腹腔镜子宫骶骨固定术治疗盆底障碍性疾病的效果。方法对14例根据POP-Q分度达Ⅱ度及Ⅲ度较年轻的盆底功能障碍性疾病患者行腹腔镜子宫骶骨固定术,应用聚丙烯网片将子宫固定于骶骨岬表面骨膜上,合并阴道前后壁膨出者分别于膀胱阴道间隙及直肠阴道间隙放置网片。结果 14例患者手术全部完成,平均手术时间(120.15±18.15)min,术中平均出血(50.15±25.17)mL,平均住院时间(3.5±2.16)d,术后随访平均为10个月。根据POP-Q分度发及问卷评价手术效果,14例患者手术后盆腔器官脱垂症状全部得到纠正,盆底结构基本恢复正常,所有病例全部治愈。结论上述方法是治疗较年轻中盆腔组织缺陷致盆腔器官脱垂患者,使之恢复盆底解剖、缓解症状、维持术后性生活质量的一种微创、安全、有效的方法。

Objective To evaluate laparoscopic uterine sacral colpopexy treatment of pelvic floor disorders effect.Methods 14 cases of POP-Q according to the index of Ⅱ and Ⅲ younger pelvic floor dysfunction in patients with laparoscopic uterine sacral fixation,using polypropylene mesh in the uterus is fixed to the sacral promontory surface periosteum,combined anterior and posterior vaginal wall prolapse were in vesicovaginal and rectovaginal clearance gap placed mesh.Results 14 cases of patients with operation is completed,the mean operation time（120.15±18.15）min,intraoperative bleeding（50.15± 25.17）mL,the average length of time（3.5±2.16）d,postoperative follow-up for an average of 10 months.According to the POP-Q index and questionnaire for evaluation of operation effect after operation,14 patients with pelvic organ prolapse symptoms are all correct,pelvic structure returned to normal,all cases were cured.Conclusion The method is the treatment of younger patients with prolapse,restore the pelvic floor anatomy,relieve symptoms,maintenance of postoperative quality of life in a minimally invasive,safe,effective method.