骶主韧带复合体、耻骨阴道肌交叉缝合术治疗子宫脱垂合并阴道前壁脱垂的临床效果

Clinical Effect of Sacral Cardinal Ligament Complex and Pubovaginal Muscle Cross Suture in Treatment of Uterine Prolapse and Anterior Vaginal Wall Prolapse

目的:分析骶主韧带复合体、耻骨阴道肌交叉缝合术治疗子宫脱垂并阴道前壁脱垂的临床效果。方法:选取2019年10月-2021年8月南充市嘉陵区人民医院收治的子宫脱垂并阴道前壁脱垂患者90例为研究对象,根据治疗方式不同分为A、B、C三组,各30例。A组采用阴式子宫切除联合骶主韧带复合体、耻骨阴道肌交叉缝合术治疗,B组采用腹腔镜子宫切除术联合网片阴道顶端骶前固定术治疗,C组采用阴式子宫切除联合阴道前壁修补术治疗。比较两组患者手术一般指标、复发情况及手术费用。结果:A组手术时间短于B组及C组,B组术中出血量少于A组及C组,B组住院时间短于A组及C组,差异均有统计学意义(P<0.05);A组、B组术后复发率低于C组,差异有统计学意义(P<0.05);A组、C组患者手术费用低于B组,差异均有统计学意义(P<0.05)。结论:阴式子宫切除联合骶主韧带复合体、耻骨阴道肌交叉缝合术治疗盆腔脏器脱垂效果佳,可降低手术时间、术中出血量、住院天数,降低复发率,减少手术费用。

Objective: To analyze the clinical effect of sacral cardinal ligament complex and pubovaginal muscle cross suture intreatment of uterine prolapse and anterior vaginal wall prolapse. Methods: A total of 90 patients with uterine prolapse and anteriorvaginal wall prolapse who were admitted to Nanchong Jialing District People’s Hospital from October 2019 to August 2021 wereselected as the study subjects. They were divided into group A, group B and group C according to the different treatment methods,with 30 cases in each group. Group A was treated with vaginal hysterectomy + sacral cardinal ligament complex and pubovaginalmuscle cross suture, Group B was treated with laparoscopic hysterectomy + mesh vaginal apical anterior sacrocolpopexy, andGroup C was treated with vaginal hysterectomy + anterior vaginal wall repair. The general operation indicators, recurrence statusand surgery costs were compared between the two groups. Results: The operation time in group A was shorter than that in groups Band C, the intraoperative bleeding volume in group B was less than that in groups A and C, and the hospital stay in group B wasshorter than that in groups A and C, with statistically significant differences(P<0.05);the postoperative recurrence rate in group Aand group B was lower than that in group C, and the difference was statistically significant(P<0.05);the cost of surgery in group Aand group C was lower than that in group B, and the difference was statistically significant(P<0.05). Conclusion: Vaginalhysterectomy combined with sacral cardinal ligament complex and pubovaginal muscle cross suture is effective in the treatment ofpelvic organ prolapse. It can reduce the operation time, intraoperative bleeding volume, the days of hospital stay, decrease therecurrence rate and the cost of surgery.