多断端悬吊术预防子宫切除术后盆底功能障碍的疗效分析

Effect of Multi-end Suspension on Prevention of Pelvic Floor Dysfunction after Hysterectomy

目的研究在腹腔镜下全子宫切除术中行骶韧带断端—圆韧带断端—阴道断端多断端悬吊术对预防盆底功能障碍的作用。方法选择80例非脱垂行腹腔镜下全子宫切除患者,随机分为观察组和对照组,分别在术前和术后12个月采用盆腔器官脱垂定量(POP-Q)、盆底疾病生活影响问卷简易版7(PFIQ-7)、盆底器官脱垂/尿失禁对性功能影响的调查问卷(PISQ-12)对所有患者进行评价。结果术后12个月随访,观察组Ba点、C点、Bp点测量值均明显高于对照组,生活质量评分明显低于对照组(均P<0.05),而Aa点、Ap点、性功能评分与对照组比较差异无统计学意义(P>0.05)。结论腹腔镜下全子宫切除术中行骶韧带断端—圆韧带断端—阴道断端(或卵巢固有韧带断端)多断端悬吊术,在术后12个月时能很好地预防阴道顶端脱垂,改善生活质量,且手术操作简单易行,易于推广开展。

Objective To study the effect of sacral ligament round ligament and ends vagina suspension in laparoscopic hysterectomy on preventing pelvic floor dysfunction.Methods In 80 cases of non-prolapse laparoscopic hysterectomy,the patients were divided into suspension group and control group.The patients were evaluated by POP-Q,PFIQ-7,PISQ-12 before and 12 months after operation.Results After 12 months follow-up,the measurement values of Ba,C and Bp in suspension group were significantly higher than those in control group,and the PFIQ-7 score was significantly lower than that in control group(P<0.05).There were no significant difference of Aa,Ap and PISQ-12 score between the two groups(P>0.05).Conclusion Multi-end suspension in the laparoscopic hysterectomy can prevent the vaginal tip prolapse,improve quality of life,and the operation is easy to promote.