腹腔镜下非网片骶前韧带悬吊术+阴道前后壁修补术治疗盆腔脏器脱垂的临床研究

Clinical study of Laparoscopic nonmesh sacral anterior ligament Suspension in the Treatment of pelvic organ prolapse

目的探讨腹腔镜下非网片骶前韧带悬吊术+阴道前后壁修补术治疗盆腔脏器脱垂的临床效果。方法选取90例盆腔脏器脱垂患者,采用抽签法分为对照组与研究组,每组45例。对照组采用阴式全子官切除术+阴道前后壁修补术治疗,研究组采用腹腔镜下非网片骶前韧带悬吊术+阴道前后壁修补术治疗。比较两组临床疗效、临床指标、并发症发生率、术后3、6、9个月复发率。结果研究组治疗总有效率为97.78%,显著高于对照组的82.22%,差异有统计学意义(P<0.05)。研究组手术时间(120±30)min长于对照组(84.21±10.54)min。研究组术后排气时间(2.31±0.56)d、术后排便恢复时间(4.68±0.68)d,均显著短于对照组的(4.42±1.10)d、(6.68±1.08)d,术中出血量(54.20±4.87)ml少于对照组的(103.24±5.21)ml,视觉模拟评分法(VAS)评分(2.01±0.32)分低于对照组的(4.30±0.54)分,差异有统计学意义(P<0.05)。研究组并发症发生率、术后3、6、9个月复发率均明显低于对照组,差异有统计学意义(P<0.05)。结论盆腔脏器脱垂患者应用腹腔镜下非网片骶前韧带悬吊术+阴道前后壁修补术,虽手术用时长,但出血量较少,恢复更快,且远期效果更显著,值得临床推广与应用。

Objective To investigate the clinical effect of laparoscopic non-mesh anterior sacral ligament suspension combined with anterior and posterior vaginal wall repair in the treatment of pelvic organ prolapse.Methods 90 patients with pelvic organ prolapse were divided into control group and study group by drawing lots,45 cases in each group.The control group was treated with total vaginal hysterectomy plus anterior and posterior vaginal wall repair,while the research group was treated with laparoscopic non-mesh sacral anterior ligament suspension plus anterior and posterior vaginal wall repair.The clinical efficacy,clinical indicators,incidence of complications and recurrence rate at 3,6 and 9 months after operation were compared between the two groups.Results The total effective rate of the study group was 97.78%,which was significantly higher than that of the control group(82.22%),with statistical significance(P<0.05).The operative time(32.62±6.84)min in the study group was higher than that in the control group(84.21±10.54)min.The postoperative exhaust time(2.31±0.56)d and postoperative defecation recovery time(4.68±0.68)d in the study group were significantly shorter than those in the control group(4.42±1.10)d,(6.68±1.08)d.The intraoperative blood loss(54.20±4.87)ml was lower than that of the control group(103.24±5.21)ml,and the visual analog scale(VAS)score(2.01±0.32)was lower than that of the control group(4.30±0.54),the difference was statistically significant(P<0.05).The incidence of complications and recurrence rate at 3,6 and 9 months after operation in the study group were significantly lower than those in the control group,with statistical significance(P<0.05).Conclusion Laparoscopic nonmesh sacral anterior ligament suspension combined with vaginal anterior and posterior wall repair in patients with pelvic organ prolapse can although the operation time is long,hut the amount of bleeding is less,and achieve more significant long-term results,which is worthy of clinical promotion and application.