自裁聚丙烯网片应用于改良腹腔镜阴道骶前固定术中的疗效观察

Clinical Observation of Polypropylene Mesh which is Applied to the Efficacy of Modified Laparoscopic Sacral Fixation Colpopexy

目的通过观察自裁聚丙烯网片在改良腹腔镜下阴道骶前固定术(laparoscopic sacral colpopexy,LSC)的临床应用疗效。方法收集30例盆腔脏器脱垂(pelvic organ prolapse,POP)患者。运用自裁聚丙烯网片行保留子宫的改良LSC,观察患者手术时间,术中出血量,术后并发症及再次手术率;术后利用主观症状改善评分(patientglobal impression of change,PGI-C)来获取患者主观满意度,利用盆腔器官脱垂定量(pelvic organ prolapse quantification,POP-Q)评分法来获取患者客观治愈率。以及利用盆底生活质量问卷(pelvic floor distress inventory-short form 20,PFDI-20;pelvic floor impact questionnaire 7,PFIQ-7)以评估患者术后生活质量。结果 30例患者全部顺利完成手术,平均手术时间(114.06±13.52)min;术中平均出血量(54±16)ml。所有患者术后子宫脱垂、阴道前壁脱垂、后壁脱垂较术前显著有改善;术后随访1年无并发症及再次手术患者。结论自裁聚丙烯网片行保留子宫的改良LSC在治疗POP患者中,达到高的主观治愈率和客观治愈率。是一种纠正多部位盆腔缺陷的手术方法,实现了腹腔镜下全盆底重建的目的。

Objective To observe the clinical application improvement in polypropylene mesh laparoscopic sacral eolpopexy （LSC）. Methods 30 cases of pelvic organ prolapse （POP） were collected. Using suicide polypropylene mesh retained uterus modified LSC, operative time, intraoperative bleeding volume, postoperative complications and reoperafion rate were observed; using the patient global impression of change （PGI-C） to obtain subjective satisfaction of patients. Using pelvic organ prolapse quantification （POP-Q） to obtain the objective cure rate of patients. The pelvic floor distress inventory-short form 20 （PFDI-20） and pelvic floor impact questionnaire 7 （PFIQ-7） were uesed to assess the quality of life of patients after surgery. Results All 30 patients were successfully completed the operation, the average operation time （ 114.06＋ 13.52） min; the average amount of bleeding （54＋16）ml. All payients had significant improvement in.uterine prolapse, anterior vaginal wall prolapse and posterior wall prolapse, and there were Tno complications an re-operation after 1 years. Conclusion Suicide polypropylene mesh in retention is a kind of surgical method to correct the defects of mttltiple parts of the pelvis, which improves LSC of uterus in patients with the treatment of pop, reaching high subjective cure rate and the objective cure rate and achieving the goal of laparoscopic total pelvic floor reconstruction.