盆底重建术预防腹腔镜辅助阴式子宫切除术后盆腔器官脱垂的近期疗效

Outcomes of pelvic reconstruction in prevention of pelvic organ prolapse in short-term after laparoscopy-assisted vaginal hysterectomy

目的观察盆底重建术预防腹腔镜辅助阴式子宫切除术盆腔器官脱垂(POP)的效果。方法行腹腔镜辅助阴式全子宫切除术的良性子宫病变患者90例随机均分为两组:对照组行常规腹腔镜辅助下阴式全子宫切除术;治疗组术中加行阴道顶端悬吊盆底重建。比较两组近期手术效果。结果两组在手术时间、出血量、排气时间和住院时间等方面均无统计学差异,且均无并发症出现。治疗组术后阴道长于对照组(P<0.05),性生活满意度高(P<0.05),且未见阴道穹窿脱垂患者。治疗组子宫脱垂患者术后膀胱颈活动度及膀胱尿道后角均较术前改善(P<0.05)。结论盆底重建预防腹腔镜辅助阴式子宫切除术POP的近期疗效确切。

Objective To observe the outcomes of pelvic reconstruction in prevention of pelvic organ prolapse（POP） in short-term after laparoscopy-assisted vaginal hysterectomy（LAVH）. Methods The LAVH was perormed in 90 cases with benign lesions of the uterus, who were equally assigned into two groups of A（conventioal LAVH plus pelvic reconstruction by suspension top of the vagina） and B（conventioal LAVH only）. The outcomes of surgery were compared between two groups. Results The operation time,blood loss, gastrointestinal recovery time and hospital stay of two groups were similar. No postoperative complications occurred in both groups. Compared to group B, group A had a longer vaginal length （P〈0. 05）, more satisfactory sexual life （P〈0. 05）, and no case with vaginal vault prolapse after surgery. The bladder neck mobility and urethral and bladder neck axis in patients with uterus prolapse in group A were decreased after surgery than those before（P〈0. 05）. Conclusion The nelvic reconstruction during LAVH can effectively prevent POP after operation in short-term.