高位宫骶韧带悬吊术治疗中盆腔缺陷的研究进展

Research Progress of High Uterosacral Ligament Suspension in the Treatment of Middle Compartment Defect

中盆腔缺陷是盆腔器官脱垂的常见类型,严重影响女性的生活质量。目前临床上治疗中盆腔缺陷的手术方式众多,但缺乏统一的术式选择标准,高位宫骶韧带悬吊术即在坐骨棘水平上1~3 cm缝合骶韧带,悬吊阴道穹隆并重建耻骨宫颈和阴道直肠筋膜,其作为采用自体组织修复中盆腔缺陷的手术,因能较好地恢复顶端支持结构、并发症少、再手术率低、费用低等优点,逐渐广泛应用于临床。就高位宫骶韧带悬吊术不同手术入路的操作步骤、临床效果及围手术期情况等进行综述。

Middle compartment defect seriously affects the quality of life with women,which is a common type of pelvic organ prolapse.At present,clinically surgical approaches for middle compartment defect is numerous,but lack a unified selection standard for surgical methods.High uterosacral ligament suspension is performed by suturing the sacral ligament 1-3 cm above the ischial spine level,suspending the vaginal vault,and reconstructing the pubocervical fascia and the rectovaginal fascia.It has been widely used as a technique that repairs middle compartment defect with autogenic tissues,because it can restore apical support structure better and has less complications,lower reoperation rates and low cost.This article is a review about procedures,therapeutical effect and perioperative situation of different surgical approaches for high uterosacral ligament suspension.