经腹子宫全切+阴道残端悬吊术治疗盆腔器官脱垂的疗效观察

Effect observation of the abdominal hysterectomy and vaginal stump suspension in the treatment of pelvic organ prolapse

目的探讨经腹子宫全切＋阴道残端悬吊术治疗女性盆腔器官脱垂（pelvic organ prolapse POP）的疗效。方法对2011年1月至2013年6月在本院妇科患POP-Q分期Ⅲ~Ⅳ期的85例患者进行回顾性分析,其中经腹子宫全切＋阴道残端悬吊术52例作为观察组,采用传统阴式子宫全切及阴道前后壁修补术33例作为对照组,比较两组患者的手术情况、术后并发症发生率、治疗效果及术后生活质量。结果观察组患者手术时间、术中出血量、术后3天最高体温、住院时间与传统阴式手术组患者相比无明显的统计学差异（P〉0.05）;导尿管保留时间明显短于对照组,两组之间差异有统计学意义（P=0.014）;术后1个月患者的生活质量差异无统计学意义（P〉0.05）;术后6个月观察组生活质量明显高于对照组,两组之间比较差异有统计学意义（P〈0.05）。结论经腹子宫全切＋阴道残端悬吊术与传统阴式手术均是治疗女性POP患者安全、有效、可行的手术方法,但经腹子宫全切＋阴道残端悬吊术术后6个月的生活质量明显高于传统阴式手术。该术式治疗盆腔器官脱垂具有手术彻底,疗效确切,避免了使用补片,术后患者随访恢复良好,无复发,生活质量好。

Objective To analyze the effect of the treatment of female POP by the abdominal hysterectomy and vaginal stump suspension.Methods The clinical datas of 85 patients with POP- Q stage Ⅲ toⅣ period,got treatment in department of gynecologyin Zhongshan Hospital of Xiamen University during January2011 and June 2013,were retrospectively analyzed.Abdominal hysterectomy and vaginal stump suspension was used in the observation group,the traditional vaginal hysterectomy and vaginal repair was used in control group,postoperative complications rate,therapeutic effect and life quality between the two groups were compared.Results The difference of operation time,bloodloss,the highest postoperative temperature,length of stay in hospital and the quality of life after 1 month were not statistically significant between the two groups（P 〉 0.05）.Retentiontime ofcatheter in the observation groupwas shorter than the control group（P = 0.014）.The quality of life was significant difference between two groups after 6 months（P 〈 0.05）.Conclusions Both methods were safe,effective and feasible for POP.However,the quality of life of the observation group is significantly higher than that of the control group.This operation is effective in treating POP.It is effective to avoid the use of patch,and the patients recovered well,no recurrence and had good quality of life.