经阴道前壁路径骶棘韧带悬吊术治疗盆腔器官脱垂的短期疗效分析

Anterior sacrospinous vaginal vault suspension in the treatment of pelvic organ prolapse:short-term clinical results of a pilot study

目的:观察经阴道前壁路径骶棘韧带悬吊术治疗盆腔器官脱垂(POP)的短期疗效及安全性。方法:回顾性分析2014年2月至2015年8月在皖南医学院附属弋矶山医院行经阴道前壁路径骶棘韧带悬吊术的51例POP患者的临床资料。观察手术时间、手术出血量、住院时间、尿管留置时间,并发症情况,治愈率,生命质量改善情况。结果:患者的平均手术时间为(75.20±24.31)min,平均术中出血量(87.65±74.72)ml,平均术后住院天数(4.31±0.75)天,平均留置尿管时间(3.50±1.30)天。完整随访51例,随访率为100.00%,3例术后复发,治愈率为94.12%。术前与术后POP-Q的Aa、Ba、Ap、Bp、C比较、盆底功能障碍问卷(PFDI-20)评分比较,差异均有统计学意义(P<0.05)。术后1月与术后6月阴道前壁Aa、Ba、C点比较,差异无统计学意义(P>0.05)。结论:经阴道前壁路径骶棘韧带悬吊术是一种安全、有效的术式,在治疗合并前盆腔缺陷的POP疾病中较传统方式具有优势。

Objective： To observe the clinical curative effect through anterior sacrospinous vaginal vault suspension in the treatment of pelvic organ prolapse.Methods： Retrospective analysis of clinical data of 51 cases of pelvic organ prolapse in Yijishan Hosptil of Wannan Medical College,from Feb.2014 to Aug.2015 underwent anterior sacrospinous vaginal vault suspension.The operation time,blood loss,hospital stay,indwelling catheter time,complications,cure rate and quality of life improvement were observed. Results： The mean operating time was（ 75.20±24.31） min,average blood loss was（ 87.65±74.72） ml,the average postoperative hospital stay was（ 4.31±0.75） days,an average indwelling time was（ 3.50±1.30） days.Complete follow-up of 51 cases,3 cases of recurrence,the cure rate was 94.12%.Preoperative and postoperative POP-Q of Aa,Ba,Ap,Bp,C compared to pelvic floor distress inventory-short form 20（ PFDI-20） scores,the differences were statistically significant（ P〈0. 05）. After 1 month and 6months after anterior vaginal wall Aa,Ba,C point difference was not statistically significant（ P〉0.05）. Conclusion： The anterior sacrospinous vaginal vault suspension is a safe and effective procedure.Compared with the posterior sacrospinous suspension technique,it has advantages in the treatment of anterior pelvic organ prolapse.