腹腔镜阴道骶骨固定术治疗女性盆腔器官脱垂的40例分析

Laparoscopic sacrocolpopexy for female pelvic organ prolapse:an analysis of 40 cases

目的探讨腹腔镜阴道骶骨固定术(laparoscopic sacrocolpopexy,LSC)治疗女性盆腔器官脱垂(pelvic organ prolapse,POP)的可行性和临床疗效。方法选取首都医科大学附属北京安贞医院2015年1月至2017年12月因POP进行子宫切除并LSC治疗患者40例,采用POP-Q分期法和盆底功能障碍问卷表(PFDI-20)、盆底功能影响问卷表(PFIQ-7)、性功能调查问卷评分(PISQ-31)评价解剖及功能疗效。患者年龄45~77岁,平均(60.8±1.4)岁;孕1~4次,平均(2.8±0.7)次;产1~3次,平均(1.7±0.5)次。结果手术时间130~330 min,平均(215.2±7.6)min;术中出血量20~300 ml,平均(82.3±9.2)ml;术后住院时间3~19 d,平均(6.6±0.4)d;术后阴道长度7.0~8.5 cm,平均7.5 cm;术后例随访8~21个月,平均11个月;术后客观无脱垂复发,客观治愈率为100%,术后自觉症状较术前改善,正常恢复性生活,主观满意度100%。结论LSC在女性盆腔器官脱垂的治疗中客观治愈率高,术后性生活满意,有一定的临床疗效。

Objective To investigate the clinical efficiency and feasibility of laparoscopic sacrocolpopexy(LSC)in the treatment of pelvic organ prolapse(POP)in women.Methods 40 cases of POP were treated with hysterectomy and LSC in Beijing Anzhen Hospital Affiliated to Capital Medical University from Jan.2015 to Dec.2017.The anatomic and functional recovery was evaluated by POP-Q,the pelvic floor inventory short form 20(PFDI-20),pelvic floor impact questionnaire short form 7(PFIQ-7),and the sexual function questionnaire short form 31(PISQ-31).Age 45-77 years(60.8±1.4)years,pregnancy times 1-4 times,(2.8±0.7)times,delivery times 1-3 times(1.7±0.5)times.Result Operation time,130-330 min,(215.2±7.6)min,intraoperative bleeding 20-300 ml,(82.3±9.2)ml,and postoperative hospitalization 3-19 days,(6.6±0.4)days.All cases were followed up for 8-21 months(mean,11 months).The overall objectivecure rate was 100%and the satisfaction rate was 100%.Conclusions Laparoscopic sacrocolpopexy is an effective treatment for women with POP.This operation has a high cure rate objectively and satisfaction rate.