腹腔镜下子宫骶前筋膜悬吊术治疗盆腔脏器脱垂的临床疗效分析

Curative Efficacy of Laparoscopic Uterus Presacral Fascia Suspension in the Treatment of Pelvic Organ Prolapse

目的:探讨腹腔镜下子宫骶前筋膜悬吊术治疗盆腔脏器脱垂(POP)患者的临床疗效及对其预后的影响。方法:回顾性分析50例行腹腔镜下子宫骶前筋膜悬吊术的POP患者(研究组)和40例行阴式子宫切除术联合阴道壁修补术的POP患者(对照组)的临床资料,比较两组围术期指标(术程、术中出血量、术后排气时间、下床活动时间、总住院时间)及并发症的发生情况,比较其术后1个月、6个月时盆底功能[盆底功能障碍问卷简表(PFDI-20)]、性功能[女性性功能评分量表(FSFI)、性生括质量问卷(PISQ-31)]评估结果的差异。结果:两组平均术程及术后并发症的发生率比较差异均无统计学意义(P>0.05);研究组术中出血量、术后排气时间、下床活动时间及总住院时间均明显短于对照组患者(P<0.05)。术后1个月、6个月时,研究组PFDI-20评分均明显低于对照组(P<0.05);FSFI、PISQ-31评分则明显高于对照组,差异均有统计学意义(P均<0.05)。结论:腹腔镜下子宫骶前筋膜悬吊术对盆底功能影响较小,且具有微创、预后恢复快的优势,有利于改善POP患者术后性生活质量。

Objective： To investigate the clinical efficacy of laparoscopic uterus presacral fascia suspension in the treatment of pelvic organ prolapse （POP） and the effect on the prognosis. Methods： The clinical data of 50 cases of patients with POP treated by la- paroscopic uterus presacral fascia suspension （study group） and 40 cases of patients with POP treated by transvaginal hysterectomy and vaginal wall repair （control group） were retrospectively analyzed. The perioperative indicators （operation time, intraoperative bleeding volume, postoperative exhaust time, ambulation time, hospitalization time） and the incidence of complications were compared between the two groups. At 1 month and 6 months after operation, the pelvic floor function [Pelvic Floor Distress Inventory （PFDI-20）], sexual function [Female Sexual Function Index （FSFI）] and quality of sexual life questionnaire （PISQ-31） were compared between two groups. Results： There was no significant difference in the mean operation time and the incidence of postoperative complications between the two groups （P〉0.05）. The intraoperative bleeding volume, postoperative exhaust time, ambulation time and total hospitalization time of study group were significantly shorter than those of the control group（P〈0.05）. At 1 month and 6 months after operation, the PFDI-20 scores of study group were significantly lower than those of the control group（P〈0.05）, and FSFI and PISQ-31 scores were significantly higher than those of the control group （P〈0.05）. Conclusion： Laparoscopic uterus presacral fascia suspension had little effect on the pelvic floor func- tion, and had the advantages of minimal invasion and rapid recovery, which was beneficial to improve the quality of life of patients with POP.