改良阴式手术治疗女性盆腔器官脱垂的效果分析

The analysis of curative effect on improved trans-vaginal surgery to female pelvic organ prolapse

目的 探讨经改良的阴式全子宫切除及阴道前后壁修补术治疗盆腔器官脱垂的临床效果，对其安全性、有效性、可行性进行分析。方法 将2008年1月～2012年6月北京市通州区妇幼保健院妇科手术治疗的子宫脱垂及前后壁膨出患者225例作为研究对象，其中传统阴式全子宫切除及前后壁修补术125例（传统组），改良阴式全子宫切除及阴道前后壁修补术110例（改良组），分析对比两组患者治疗效果及术后并发症的发生率。结果 改良组手术时间[（65．25±15．65）min]、总住院时间[（6．70±2．30）d]和并发症发生率（2．70％）明显少于传统组[（90．50±30．20）min、（9．12±2．13）d、6．40％]，改良组术后治愈率（90．9％）高于传统组（68．8％），差异均有统计学意义（均P〈0．05）；改良组出血量、排气时间、术后病率分别为（155．80±28．32）mL、（22．56±12．15）h、0．91％，传统组出血量、排气时间、术后病率分别为（170．35±20．05）mL、（24．15±10．50）h、0．24％，两组比较差异无统计学意义（P〉0．05）。结论 改良阴式全子宫及阴道前后壁修补术治疗盆腔脏器脱垂效果较满意，具有微创、安全、术后恢复快、并发症发生率较低等特点，值得进一步推广。

Objective To discuss the curative effect on improved trans-vaginal hysterectomy plus anterior and posterior vaginal wall repair to female pelvic organ prolapse, and analyze the safety, effectiveness and feasible. Methods The clinical data of 225 patients with uterine prolapse and anterior and posterior vagina prolapse cured by vaginal surgery in Gynecology Department of Tongzhou Maternal and Child Health Hospital of Beijing City from January 2008 to June 2012 were selected as the study objects, 125 cases with traditional trans-vaginal surgery （traditional group） and 110 cases of improved trans-vaginal surgery （improved group）. The clinical efficacy＇and incidence of complications after the treatment of two groups were compared and analyzed. Results The operative time, total hospital stay, incidence of complications in the improved group were （65.25±15.65） min, （6.70±2.30） d, 2.70% respectively, which were obviously less than the traditional group [（90.50±30.20） min, （9.12±2.13） d, 6.40%], and the cure rate after surgery in the improved group （90.9%） was higher than that in the traditional group （68.8%）, the differences were statistically significant （all P 〈 0.05）. The blood loss, intestinal recovery time and postoperative morbidity was （155.80±28.32） mL, （22.56±12.15） h, 0.91% in the improved group, and （170.35±20.05） mL, （24.15±10.50） h, 0.24% in the traditional group respectively, there were no significantly differences between the two groups （P 〉 0.05）. Conclusion Improved trans-vaginal hysterectomy plus anterior and posterior vaginal wall repair have satisfactory effect in the treatment of pelvic organ prolapse, with a minimally invasive, safe, rapid postoperative recovery and lower incidence of postoperative complications characteristics, worthy of further promotion.