桥式缝合阴道筋膜在子宫脱垂及阴道前后壁脱垂中的应用

The Application of Vaginal Fascia Suture Bridge in Uterine Prolapse and Anterior and Posterior Vaginal Wall Prolapse

目的探讨桥式缝合阴道筋膜治疗子宫脱垂及阴道前后壁脱垂的临床效果。方法选取2010年4月至2013年4月在广饶县中医院妇产科住院手术的70例子宫脱垂及阴道前后壁脱垂患者为研究对象,按照随机数字表法分成两组,阴式子宫切除组(35例)予以传统的阴式子宫切除术,桥式缝合阴道筋膜组(35例)采用桥式缝合阴道筋膜方法,治疗1周后观察两组在临床疗效、性交疼痛、并发症发生情况及手术时间、术中出血量、术后排气时间、术后排便时间、疼痛评分等。结果阴式子宫切除组手术时间显著短于桥式缝合阴道筋膜组[(83.1±18.4)min比(123.2±13.5)min,P<0.05],术后排气时间、术后排便时间显著长于桥式缝合阴道筋膜组[(20.4±8.4)h比(17.3±3.4)h、(3.0±1.4)d比(2.2±1.1)d,P<0.05],术中出血量、疼痛积分显著高于桥式缝合阴道筋膜组[(217.4±67.5)m L比(174.3±43.5)m L、(7.1±1.3)分比(5.2±1.4)分,P<0.05]。结论桥式缝合阴道筋膜可提高子宫脱垂及阴道前后壁脱垂临床效果,降低术后并发症。

Objective To investigate clinical effects of the vaginal fascia suture bridge in treatment of uterine prolapse and anterior and posterior vaginal wall prolapse. Methods A total of 70 patients with uterine prolapse and anterior and posterior vaginal wall prolapse hospitalized in Guangrao County Hospital from Apr. 2010 to Apr. 2013 were chosen in the study,according to urandom number table method they were divided into two groups： vaginal hysterectomy group of 35 cases,given traditional vaginal hysterectomy; vaginal fascia suture bridge group of 35 cases,given vaginal fascia suture bridge. One week after treatmentthe clinical efficacy,sexual intercourse pain,operative time,blood loss,postoperative exhaust time,postoperative bowel movement,and pain score were observed. Results The operative time of vaginal hysterectomy was significantly shorter than the vaginal fascia suture bridge group [（ 83. 1 ± 18. 4） min vs（ 123. 2 ± 13. 5） min,P 0. 05],postoperative exhaust time,postoperative bowel movement time was significantly longer than the vaginal fascia suture bridge group [（ 20. 4 ± 8. 4） h vs（ 17. 3 ± 3. 4） h,（ 3. 0 ± 1. 4） d vs（ 2. 2 ± 1. 1） d,P 0. 05],blood loss,pain score was significantly higher than vaginal fascia suture bridge group [（ 217. 4 ±67. 5） m L vs（ 174. 3 ± 43. 5） m L,（ 7. 1 ± 1. 3） scores vs（ 5. 2 ± 1. 4） scores,P 0. 05]. Conclusion The vaginal fascia suture bridge can improve the clinical effect of uterine prolapse and anterior and posterior vaginal wall prolapse,and reduce postoperative complications.