经腹腔镜子宫/阴道骶骨固定术与改良式全盆底功能重建术治疗盆腔脏器脱垂的疗效比较

Efficacy of laparoscopic uterine/sacral colpopexy and modified total pelvic floor reconstruction for treating pelvic organ prolapse:a comparative study

目的比较改良式全盆底功能重建术(MTPFR)与经腹腔镜子宫/阴道骶骨固定术(LUSC)治疗盆腔脏器脱垂(POP)的临床效果。方法将86例POP患者随机分为对照组与观察组,每组43例。对照组患者给予MTPFR治疗,观察组患者给予LUSC治疗。比较两组患者盆底功能、性生活质量改善情况、病情恢复效果、住院时间、治愈率、复发率,以及并发症发生情况等。结果两组患者术后12个月POP定量评分中的各项评分较术前均有明显改善,且观察组改善程度均优于对照组(均P<0.05)。观察组术后住院时间短于对照组,主观满意度、治愈率均高于对照组,并发症发生率、脱垂复发率均低于对照组(均P<0.05)。两组患者术后盆底功能障碍性疾病症状问卷简表评分、排便症状评分、排尿症状评分、POP症状评分、性生活质量问卷评分均高于术前,性生活主观症状改善评分均低于术前,且观察组各评分均高于对照组(均P<0.05)。结论与MTPFR相比,采用LUSC治疗POP患者可降低术后并发症发生率,缩短患者术后住院时间,且患者盆底功能、性生活质量改善效果更好。

Objective To compare the clinical efficacy of modified total pelvic floor reconstruction(MTPFR) and laparoscopic uterine/sacral colpopexy(LUSC) in the treatment of pelvic organ prolapse(POP).Methods A total of 86 patients with POP were randomly divided into control group and observation group,with 43 cases in each group.The patients in the control group were treated with MTPFR,and the patients in the observation group were treated with LUSC.The pelvic floor function,the improvement in quality of sexual life,the effect of disease recovery,hospital stay,curative rate,recurrence rate,and the incidence of complications were compared between the two groups.Results After 12 months of operation,the various scores of POP quantitation score of both groups were significantly improved as compared with preoperation,and the improvement of the observation group was superior to that of the control group(all P<0.05).In comparison with the control group,the observation group had shorter postoperative hospital stay,higher subjective satisfaction and curative rate,lower incidence rate of complications and recurrence rate of prolapse(all P<0.05).After operation,the patients of both groups obtained higher the scores of Pelvic Floor Distress Inventory-short form 20,symptom scores for defecation,urination and POP,and scores for quality of sexual life questionnaire,and lower scores for subjective symptom improvement of sexual life(all P<0.05) as compared with preoperation;in addition,the various scores of the observation were higher than those of the control group(all P<0.05).Conclusion Compared to MTPFR,LUSC applied to treating POP patients can reduce the incidence of postoperative complications,shorten the postoperative hospital stay,and achieve better improvement in patients′ pelvic floor function and quality of sexual life.