盆底磁刺激联合腹腔镜下高位骶韧带悬吊治疗中盆腔缺陷的效果观察

Observation on the Effect of Pelvic Floor Magnetic Stimulation Combined with Laparoscopic High Uterosacral Ligament Suspension in the Treatment of Middle Pelvic Defects

目的:观察盆底磁刺激联合腹腔镜下高位骶韧带悬吊(HUS)治疗中盆腔缺陷的效果。方法:选取2018年1月-2021年1月郑州大学第三附属医院盆底重建病区收治的68例中盆腔缺陷患者,按照治疗方法将其分为对照组和观察组,每组34例。观察组采用盆底磁刺激联合腹腔镜下HUS,对照组采用腹腔镜下HUS。比较两组围手术期指标、术后并发症发生情况、POP-Q指示点(Aa、Ba、C、Tvl、Ap、Bp)测量值、PFDI-20评分、PFIQ-7评分及盆底肌力。结果:治疗后,两组POP-Q指示点(Aa、Ba、C、Ap、Bp)测量值均优于治疗前,差异均有统计学意义(P<0.05);治疗后,两组POP-Q各指示点(Aa、Ba、C、Tvl、Ap、Bp)测量值比较,差异均无统计学意义(P>0.05);治疗后,两组PFDI-20评分、PFIQ-7评分和Ⅰ、Ⅱ类肌纤维肌力均优于治疗前,且观察组均优于对照组,差异均有统计学意义(P<0.05)。结论:腹腔镜下HUS治疗中盆腔缺陷效果可靠,联合盆底磁刺激可以显著提高治疗效果,值得临床推广。

Objective:To observe the effect of pelvic floor magnetic stimulation combined with laparoscopic high uterosacral ligament suspension (HUS) in the treatment of middle pelvic defects.Method:A total of 68 patients with middle pelvic defects admitted to the pelvic floor reconstruction ward of the Third Affiliated Hospital of Zhengzhou University from January 2018 to January 2021 were selected,which were divided into control group and observation group according to treatment method,with 34 cases in each group.The observation group received pelvic floor magnetic stimulation combined with laparoscopic HUS,and the control group received laparoscopic HUS.Perioperative indicators,postoperative complications,POP-Q indicator points (Aa,Ba,C,Tvl,Ap,Bp),PFDI-20 score,PFIQ-7 score and pelvic floor muscle strength were compared between two groups.Result:After treatment,the measured values of POP-Q indicator points (Aa,Ba,C,Ap,Bp) in both groups were better than those before treatment,the differences were statistically significant (P<0.05);after treatment,there were no significant differences in the measurement values of POP-Q indicator points (Aa,Ba,C,Tvl,Ap and Bp) between two groups (P>0.05);after treatment,PFDI-20 scores,PFIQ-7 scores and muscle fiber strength of class Ⅰ and Ⅱ in both groups were better than those before treatment,and those in the observation group were better than those in the control group,the differences were statistically significant (P<0.05).Conclusion:Laparoscopic HUS has a reliable curative effect in the treatment of middle pelvic defects,combining with pelvic floor magnetic stimulation can significantly improve the therapeutic effect,it is worthy of clinical promotion.