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对膀胱功能恢复的影响

Effect of transvaginal anterior pelvic floor reconstruction combined with sacrospinal ligament suspension on the recovery of bladder function in pelvic organ prolapse

目的 探讨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(POP)对膀胱功能恢复的影响。方法 选取2018年6月至2020年9月安庆市立医院收治的82例POP行手术治疗的患者作为研究对象,进行回顾性分析。依据不同手术方式,将采用经阴道前盆底重建术+骶棘韧带悬吊术治疗的42例患者纳入A组,将采用单纯经阴道前盆底重建术的40例患者纳入B组。比较两组围手术期指标、盆腔器官脱垂情况、膀胱功能分级、残余尿量、术后并发症。结果 A组手术时间长于B组,术中出血量大于B组,差异具有统计学意义(P<0.05);两组尿管留置时间、术后住院时间比较,差异无统计学意义(P>0.05);A组术后6个月盆腔器官脱垂问卷(POP-Q)分度改善情况优于B组,差异具有统计学意义(P<0.05);A组术后6个月POP-Q指示点(C、D)数值小于B组,残余尿量少于B组,差异具有统计学意义(P<0.05);两组术后并发症发生率比较,差异无统计学意义(P>0.05);两组术后1年复发率比较,差异无统计学意义(P>0.05)。结论 POP患者采用经阴道前盆底重建术联合骶棘韧带悬吊术治疗,可有效改善盆腔器官脱垂状态,术后膀胱功能恢复良好,安全性较高。

Objective To explore the effect of transvaginal anterior pelvic floor reconstruction combined with sacrospinal ligament suspension on the recovery of bladder function in pelvic organ prolapse(POP).Methods A retrospective analysis was performed on the 82 patients with POP undergoing surgical treatment in Anqing Municipal Hospital between June 2018 and September 2020.According to different surgical methods,they were divided into group A(42 cases,transvaginal anterior pelvic floor reconstruction combined with sacrospinal ligament suspension) and group B(40 cases,transvaginal anterior pelvic floor reconstruction).The perioperative indexes,POP conditions,grading of bladder function,residual urine volume and postoperative complications in the two groups were compared.Results The operation time in group A was longer than that in group B,and intraoperative blood loss was more than that in group B(P0.05).At 6 months after surgery,improvement of pelvic organ prolapse questionnaire(POP-Q) indexing in group A was better than that in group B(P0.05),and the difference in the recurrence rate between the two groups was not statistically significant at 1 year after surgery(P>0.05).Conclusions Transvaginal anterior pelvic floor reconstruction combined with sacrospinal ligament suspension can effectively improve pelvic organ prolapse status of patients with POP,with good recovery of bladder function,and high safety.