经阴道前盆底重建术联合骶棘韧带悬吊术治疗盆腔脏器脱垂的疗效分析

Transvaginal Anterior Pelvic Floor Reconstruction Combined with Sacrospinal Ligament Suspension for Pelvic Organ Prolapse

目的探讨盆腔脏器脱垂实施经阴道前盆底重建术联合骶棘韧带悬吊术治疗的疗效。方法将妇科80例盆腔脏器脱垂患者(2017年1月—2018年6月间)纳入研究,使用计算机进行随机分组,分为悬吊组(实施骶棘韧带悬吊术治疗)、联合组(实施经阴道前盆底重建术联合骶棘韧带悬吊术治疗),各40例,分析患者手术指标、术后恢复指标、术后并发症、疗效、远期病情、生活质量、性生活质量及疾病复发状况。结果悬吊组患者手术出血量(55.6±7.2)mL、手术时间(55.6±6.4)min明显低于联合组的(75.3±8.5)mL、(70.5±7.6)min(t=11.185、9.484,P<0.05)。联合组术后并发症总发生率(5.0%)明显低于悬吊组(20.0%),差异有统计学意义(χ2=4.114,P<0.05)。联合组总有效率(97.5%)明显高于悬吊组(80.0%),差异有统计学意义(χ2=6.135,P<0.05)。悬吊组术后1年PFDI-20、PFIQ-7、PISQ-12评分为(22.5±6.2)分、(21.5±3.8)分、(35.6±3.5)分明显高于联合组,差异有统计学意义(t=5.069、6.887、6.935,P<0.05)。结论盆腔脏器脱垂实施经阴道前盆底重建术联合骶棘韧带悬吊术治疗效果良好,虽会增加手术出血,延长手术时间,但并发症少,恢复更快,远期预后良好,可改善生活质量及性生活质量,降低复发风险。

Objective To investigate the effect of transvaginal anterior pelvic floor reconstruction combined with sacrospinal ligament suspension in the treatment of pelvic organ prolapse.Methods 80 gynecologic patients with pelvic organ prolapse(January 2017 to June 2018)were enrolled in the study.They were randomly divided into suspension group(sacrospinal ligament suspension therapy)and combination group(transvaginal anterior pelvic floor reconstruction combined with sacrospinal ligament suspension therapy),40 cases each.Indicators,post-operative recovery indicators,post-operative complications,efficacy,long-term condition,quality of life,quality of sexual life and disease recurrence.Results The bleeding volume and operation time of suspension group were(55.6±7.2)mL and(55.6±6.4)min respectively,which were significantly lower than those of combined group(75.3±8.5)mL,(70.5±7.6)min(t=11.185,9.484,P<0.05).The total incidence of postoperative complications in the combined group(5.0%)was significantly lower than that in the suspension group(20.0%),with statistically significant differences(χ2=4.114,P<0.05).The total effective rate of the combined group(97.5%)was significantly higher than that of the suspension group(80.0%),with statistically significant differences(χ2=6.135,P<0.05).The one-year postoperative PFDI-20,PFIQ-7,and PISQ-12 scores in the suspension group were(22.5±6.2)points,(21.5±3.8)points,and(35.6±3.5)points,which were significantly higher than those in the combination group,with statistically significant differences(t=5.069,6.887,6.935,P<0.05).Conclusion Transvaginal anterior pelvic floor reconstruction combined with sacrospinal ligament suspension for pelvic organ prolapse has good therapeutic effect.Although it can increase bleeding and prolong operation time,it has fewer complications,quicker recovery and good long-term prognosis.It can improve the quality of life and sexual life and reduce the risk of recurrence.