腹腔镜高位骶韧带联合圆韧带悬吊术治疗子宫脱垂的临床效果分析

Analysis of the effect of laparoscopic high uterosacral ligament and round ligament suspension in the treatment of uterine prolapse

目的探讨腹腔镜高位骶韧带联合圆韧带悬吊术治疗POP-Q分期Ⅱ~Ⅲ期子宫脱垂患者的临床疗效。方法回顾性分析青岛市市立医院2011年8月至2015年8月因POP-Q分期Ⅱ~Ⅲ期子宫脱垂行腹腔镜子宫全切+高位骶韧带、圆韧带悬吊术的患者共76例为研究组,同期行腹腔镜子宫全切+高位骶韧带悬吊术的患者41例为对照组,采用POP-Q评分、视觉模拟满意度(VAS)、盆底障碍影响简易问卷(PFIQ-7)和性生活质量问卷(PISQ-12)评价手术主客观满意度、生活质量及性生活质量。结果两组术后POP-Q各指示点、VAS评分比较差异无统计学意义(P>0.05);术后PFIQ-7评分研究组97.05±22.89,对照组104.83±10.44,差异有统计学意义(P<0.05);术后PISQ-12评分研究组39.54±3.67,对照组37.09±2.85,差异有统计学意义(P<0.05)。研究组复发4例(5.26%),对照组复发8例(19.51%),差异有统计学意义(P<0.05)。结论腹腔镜下高位骶韧带联合圆韧带悬吊术可有效治疗POP-Q分期Ⅱ~Ⅲ期的子宫脱垂患者,远期效果好,可明显改善患者的生活质量。

Objective To evaluate the effect of laparoscopic high uterosacral ligament and round ligament suspension in the treatment of stage Ⅱ-Ⅲ uterine prolapse.Methods From August 2011 to August 2015,76 cases with stage Ⅱ-Ⅲ uterine prolapse underwent laparoscopic hysterectomy with high uterosacral and round ligament suspension and 41 cases underwent laparoscopic hysterectomy with high uterosacral ligament suspension. POP-Q（Pelvic Organ Prolapse Quantification ）, VAS（Visual Analogue Satisfaction Scale）, Pelvic Floor Impact Questionnaire Short Form （PFIQ-7） and Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire Short Form （PISQ-12） were recorded and compared between the two groups.Results There was no statistically significant difference in the POP-Q and VAS score after operation between the two groups. PFIQ-7 score of research group after operation was 97.05±22.89, control group 104.83±10.44; PISQ-12 score of research group after operation was 39.54±3.67, control group 37.09±2.gS;the difference was statistically significant （P〈0.05）.The recurrence rate of research group was 5.26%, control group 19.51% , the difference being statistically significant （P〈0.05）.Conclusion Laparoscopic high uterosacral ligament and round ligament suspension is a safe and efficient method in the treatment of stage 1I -IlI uterine prolapse. The long-term effect is good and it can improve the quality of life.