腹腔镜下子宫骶骨固定术治疗子宫脱垂41例疗效分析

Therapeutic effects of laparoscopic uterus sacrum fixation on 41 cases of uterine prolapse

目的 探讨腹腔镜下子宫骶骨固定术治疗子宫脱垂的疗效。方法 对41例子宫脱垂患者进行腹腔镜下子宫骶骨固定术,记录患者手术时间、术中出血量等。术后第1、3、6、12个月进行门诊随访,对比手术前后生活质量评分。结果 41例均成功完成手术,手术时间平均（65.8±22.4）min,术中出血量（40.2±21.2）ml。术中无血管、输尿管及直肠损伤。术后肛门排气时间为6~8 h,住院3~7 d,无肠梗阻及肠粘连发生。术后随访12个月内,手术治疗有效率为100%,无复发病例发生。术后3个月POPDI-6、CRADI-8、UDI-6及PFDI-20得分均较术前显著降低（P〈0.01）,并且在术后6、12个月维持稳定。结论 腹腔镜下子宫骶骨固定术治疗子宫脱垂具有创伤小、操作简便、副作用少、疗效显著、复发率低等优点,且可显著改善患者生活质量,值得推广。

Objective To explore the therapeutic effects of laparoscopic uterus sacrum fixation on uterine prolapse. Methods 41 patients with uterine prolapse were treated by laparoscopic uterus sacrum fixation. The operative time and perioperative blood loss were recorded. Clinic followed-up was made 1 month, 3, 6, and 12 months after the operation. Comparison was made between the life quality scaled before and after the operation. Resulls The operations were successfully completed in all the 41 cases. The average operation time was （65.8±22.4）min; the perioperative bleeding volume was （40.2±21.2）ml. There was no injury of blood vessel, ureter, and rectum during the operation. The passage of gas by anus happened 6-8 h after the operation, and the hospitalization days were 3-7 d. There was no intestinal obstruction and adhesions occurred. During the 12 months of follow-up, the therapeutic effective rate was 100%, and there was no recurrence. Three months after the operation, the scales of POPDI-6, CRADI-8, UDI-6, and PFDI-20 all decreased compared with those before the operation （P〈 0.01） and maintained stable 6 and 12 months after the operation. Conclusion The laparoscopic uterus sacrum fixation for uterine prolapse has the merits of small trauma, convenient operation, less side effects, evident curative effects, and lower recurrence rate. It can improve the patients＇ quality of life and is worth to be promoted.