子宫脱垂患者行改良腹腔镜子宫悬吊术的有效性及安全性

Uterine Prolapse Underwent Laparoscopic Uterine Suspension Surgery Improved Efficacy and Safety

目的探讨分析子宫脱垂患者行改良腹腔镜子宫悬吊术的有效性及安全性。方法回顾性分析该院2014年12月—2015年12月收治的52例子宫脱垂患者,对所有患者实施了改良腹腔镜子宫悬吊术,观察患者手术平均时间、术中平均出血量、术后使用导尿管平均时间及并发症情况。结果所有患者均顺利完成手术,手术平均时间为(40.2±6.3)min,术中平均出血量为(80.3±4.5)m L,术后患者使用导尿管平均时间为(3.0±1.5)d,术前术后差异有统计学意义(P<0.05)。术后无感染、网片侵蚀、无网片暴漏及血肿行程等情况。其中有2例患者术中同时行宫颈部分切除术,且术后1个月随访检查发现穹窿切口已完全吸收所有缝线,但切口则出现网片暴漏现象及未完全愈合情况,所以要求患者在术后每周都接受表皮细胞生长因子治疗,治疗1个月后发现切口已完全愈合。有3例患者表示术后下腹有痛感,没有对其特别处理,因此患者表示均可耐受,3个月后腹痛自行缓解。结论改良腹腔镜子宫悬吊术治疗子宫脱垂效果显著,能有效改善临床症状和患者生活质量,安全,并发症少,能满足患者保留子宫的愿望,值得临床推广和应用。

Objective To investigate the analysis uterine prolapse patients underwent modified laparoscopic uterine suspension surgery efficacy and safety. Methods A retrospective analysis of 29 cases of uterine prolapse patients in our hospital in December 2014 to December 2015 admitted to all patients improved implementation of laparoscopic uterine suspension surgery, treatment and analysis of patient complications. Results All patients were successfully operated,mean operative time was（40.2±6.3）min, mean intraoperative blood loss was（80.3±4.5）mL, patients using catheter average time（3.0 ± 1.5） d; There was no infection, mesh erosion, storm drain and no mesh hematoma travel and so on.There are two cases in which patients undergoing cervical both partial resection and after 1 month follow-up examination revealed fornix incision has completely absorbed all the stitches, but the incision appeared mesh storm drain phenomenon and the situation is not completely healed, it requires patients after every week after receiving epidermal growth factor treatment, a month has been found incisions healed completely. 3 patients showing lower quadrant pain after surgery, it is no special treatment, and the patient can tolerate represented, three months after the pain and relieve itself. Conclusion The modified laparoscopic uterine suspension surgery for uterine prolapse significant effect, can effectively improve the clinical symptoms and quality of life, safety, fewer complications, to meet the desire to retain the uterus of the patient, and is worthy of clinical application.