坐骨棘筋膜固定缝合术治疗盆腔器官脱垂的疗效评价

Evaluation the Efficacy on Ischial Spinous Fascia Fixation in Treatment of Pelvic Organ Prolapse

目的：探讨坐骨棘筋膜固定缝合术治疗盆腔器官脱垂（POP）的疗效。方法：我院行子宫切除术同时行坐骨棘筋膜固定缝合术的18例POP-Q分度Ⅱ-Ⅲ度POP患者,记录入院资料和围手术期参数,术前、术后POP-Q分类法评估Aa、AP、C、Ba、Bp、D点测定的变化,以评价治疗效果。结果：18例患者术中平均出血量为50.0±10.5 ml,平均手术时间为50.0±8.6分钟,术后平均住院时间为4.2±0.8天,平均手术费用为8605±2164元,术后中位随访时间为20个月（12-36个月）。术前、术后12月C点分别为＋2.2±0.7 cm、-5.6±0.5 cm,D点-3.9±0.9 cm、-7.0±0.0 cm,术前、术后比较差异有统计学意义（P〈0.01）。18例患者术后脱垂的系列症状减轻或消失,16例术后3月即恢复正常性生活。结论：坐骨棘筋膜固定缝合术术后POP-Q分类法评估C点、D点及生活质量较术前明显改善,性生活较快恢复正常,是一种安全、经济、疗效满意的术式。

Objective： To explore the efficacy of the ischial spinous fascia fixation in treatment of pelvic organ prolapse（ pelvic organ prolapse,POP）. Methods： 18 cases of the POP-Q stageⅡ-Ⅲ with pelvic prolapse undergone hysterectomy combined with ischial spine fixation in our hospital during september,2011-June,2014. Admission information and perioperative parameters,preoperative and variegation postoperative POP-Q indexing and change of 6 points： Aa,AP,C,Ba,Bp,D were recorded,so that to evaluate the treatment efficacy. Results： Among the 18 cases,the average bleeding of this operation way was 50. 0 ±10. 5 ml,the average operation average time was50. 0±8. 6 min,the average time in hospital after operation was 4. 2±0. 8 d,the average cost of surgery was 8605± 2164 yuan,the median post-operation follow up time was 20 months（ 12-36 months）. the C point preoperative and 1 2 m onths postoperation was ＋ 2. 2 ± 0. 7 cm,- 5. 6 ± 0. 5 cm,respectively,and the D point was-3. 9±0. 9 cm,-7. 00±0. 0 cm,respectively,the differences on the C point and D point between preoperation and postoperation were both statistically significant（ P〈0. 01）. 18 patients recovered without discomfort post-operation,16 patients had normal sexual life 3 months after operation. Conclusions： Ischial spinous fascia fixation can obviously improve the postoperative POP-Q indexing and life quality with fast sex life recovery,therefore it is a safe and economic treatment for pelvic organ prolapse with satisfactory efficacy.