桥式网片修补联合圆韧带悬吊术治疗阴道穹隆脱垂38例

Clinical Study of 38 Cases of Bridge Type of Joint Circular Ligament Repair for Vaginal Fornix Prolapse

目的:探讨应用桥式网片修补联合圆韧带悬吊术治疗子宫脱垂合并阴道壁、穹隆脱垂,进行中后骨盆重建的可行性和有效性。方法:对38例有不同程度缺陷的盆腔器官膨出患者进行阴式子宫切除阴道壁修补术同时行桥式网片修补联合圆韧带悬吊术,在应用聚丙稀网片加固阴道膀胱、直肠筋膜的同时,用圆韧带残端悬吊阴道顶端,完成中后盆底重建。根据国际尿控协会制定的盆腔器官脱垂定量(POP-Q)分度法,评价手术效果。结果:手术时间平均为115 min,出血量平均为100 mL。38例患者的阴道脱垂全部得到纠正;平均随访26个月,均未出现阴道扭曲、缩短,无阴道穹隆脱垂,无性生活障碍。无复发;各种症状改善率≥50%。结论:对于子宫脱垂合并阴道壁、穹隆脱垂的患者,在切除子宫的同时应用桥式网片修补联合圆韧带悬吊术进行中后盆底重建,短期效果稳定,降低了复发的可能。

Objiective:Explore the feasibility and effectiveness of the reconstruction of the middlecomparment and posteriocomparment by applicating bridge type of joint circular ligament repair to treat the prolapsus of uterine and vaginal wall、vaginal fornix.Methods:Of 38 patients with different degree defect of pelvic organ prolapse,doing vaginal hysterectomy and then vaginal wall repair simultaneously bridge type of joint circular ligament repair,useing Polypropylene patch to reinforce vaginal bladder、rectum fascia while hanging the vaginal top with round the residual ligament,to complete the reconstruction of the middlecomparment and posteriocomparmen.According to the international association of urine control pelvic organ prolapse quantitative(POP-Q) dividing method,the evaluation of surgical effects.Results:Surgery for an average of 115min,bleeding,average for 100 ml.38 patients with vaginal vault prolapse all corrected.A median follow-up of 26 months,all did not appear vagina,shorten the distortion,vaginal vault prolapse,asexual life obstacle.Without relapse.Various symptoms experiment it 50% period.Conclusion:For uterine prolapse,vaginal vault prolapse,merger,the patients in the application of hysterectomy at bridge type of joint circular ligament repair of suspension after pelvic reconstruction,short-term effect stable,reduce the recurrence of may.