子宫切除术应用改良阴道残端缝合圆韧带悬吊术的效果

Effect of Hysterectomy with Modified Vaginal Stump Suture and Round Ligament Suspension

目的探讨改良阴道残端缝圆韧带悬吊术对子宫切除术后女性中盆腔脱垂的预防效果。方法选取2017年1月至2018年7月在我院行全子宫切除术患者180例,根据选取的治疗方案分为观察组(n=89)和对照组(n=91),对照组给予腹腔镜下子宫切除术,观察组在对照组基础上给予改良阴道残端缝圆韧带悬吊术,观察两组手术情况、盆腔测量指标及并发症,采用盆底功能障碍问卷20(PFDI-20)评价患者生活质量,采用性生活质量问卷短表12(POSQ-12)评价患者性生活质量。结果观察组和对照组手术时间、术中出血量和术后住院天数比较差异无统计学意义(P>0.05);观察组和对照组术后VAS评分比较差异无统计学意义(P>0.05);观察组术后6个月C、Aa、Ba、Ap和Bp分别为(-7.82±0.67)cm、(-2.67±0.54) cm、(-2.25±0.41) cm、(-2.22±0.71) cm和(-2.32±0.38) cm,显著低于对照组(P>0.05);观察组术后6个月PFDI-20评分为(20.04±6.72)分,显著低于对照组(P>0.05),而POSQ-12评分为(32.29±7.81)分,显著高于对照组(P>0.05);观察组和对照组术后均无腹部切口愈合不良等并发症发生。结论改良阴道残端缝圆韧带悬吊术可有效维护子宫切除术后患者盆底结构,改善患者盆底功能,提高患者性生活质量。

Objective To explore the effect of modified vaginal stump round ligament suspension on the prevention of pelvic prolapse in women after hysterectomy.Methods From January 2017 to July 2018,180 patientswho underwent total hysterectomy in our hospital were selected.Basedonselected treatment plan,they were divided into observation group(OG,n=89)and control group(CG,n=91).CG was given laparoscopic hysterectomy,while OG was given modified vaginal stump round ligament suspension on the basis of CG.The operation status,pelvic measurement indicators and complications were observed.Pelvic floor distress inventory-short form 20(PFDI-20)was used to evaluate life quality,and short form 12(POSQ-12)of sexual life was evaluated.Results There was no statistically significant difference in operation time,intraoperative blood loss and postoperative hospitalization days(P>0.05).There was no statistically significant difference in postoperative VAS score(P>0.05).At 6 months after operation,C,Aa,Ba,Ap and Bp of OG were(-7.82±0.67)cm,(-2.67±0.54)cm,(-2.25±0.41)cm,(-2.22±0.71)cm and(-2.32±0.38)cm,respectively,which were significant lower than CG(P>0.05).PFDI-20 score at 6 months after surgery of OG was(20.04±6.72)points,which was significantly lower than CG(P>0.05).While POSQ-12 score was(32.29±7.81)points,which was significantly higher than CG(P>0.05).There were no complications such as poor abdominal incision healing in two groups.Conclusion Modified vaginal stump suture round ligament suspension could effectively maintain pelvic floor structure after hysterectomy,improve pelvic floor functionand sex quality.