阴式CY Liu式盆底修复术治疗盆腔器官脱垂的临床效果研究

Clinical study of pelvic organ prolapse treated with vaginal CY Liu pelvic restoration

目的探讨阴式CY Liu式盆底修复术治疗盆腔器官脱垂(POP)的临床效果。方法分析30例行阴式CY Liu式盆底修复术的POP患者的临床资料,观察手术指标、术后疗效、不适症状、主观治愈率和客观治愈率、术后性生活及生活质量情况。结果30例患者全部完成阴式CY Liu式盆底修复术,其中5例为阴道穹窿脱垂,9例未切子宫,16例切除子宫,合并阴道前壁脱垂的同时行阴道前壁修补术,合并阴道后壁脱垂的同时行阴道后壁修补及会阴体重建术,合并尿失禁的行尿道折叠术。同时合并阴式子宫切除手术时间为(64.0±4.3)min、出血量为(42.0±7.9)ml;阴式CY Liu式盆底修复术时间为(30.0±3.6)min,出血量为(20.5±6.2)ml,术后保留尿管时间为(2.6±0.8)d,无术后尿潴留发生,肛门排气时间为(1.1±0.4)d,术后住院时间为(5.3±2.5)d,3例发生术后骶尾部不适,外阴感觉、下肢感觉及肌张力均正常,对症处理物理治疗,疼痛不适感均在5~7 d后自行缓解。出院时均大小便正常,无发热及血肿形成,无术后感染发生,阴道轴向无偏移。术后随访12~24个月,平均随访(6.8±3.6)个月,主观治愈率和客观治愈率均为100%(30/30)。患者术后性生活及生活质量均满意。结论阴式CY Liu式盆底修复术治疗POP的疗效确切,安全可行,值得在临床上推广应用。

Objective To discuss the clinical effect of vaginal CY Liu pelvic restoration in the treatment of pelvic organ prolapse(POP).Methods The clinical data of 30 patients with POP who underwent vaginal CY Liu pelvic restoration was analyzed,and the surgical index,postoperative efficacy,discomfort symptoms,subjective and objective cure rates,postoperative sexual life and quality of life were observed.Results All 30 patients completed the vaginal CY Liu pelvic restoration,including 5 cases of vaginal vault prolapse,9 cases without hysterectomy,16 cases with hysterectomy.Patients with anterior vaginal wall prolapse were also treated with anterior vaginal wall restoration,patients with posterior vaginal wall prolapse were also treated with posterior vaginal wall restoration and perineal reconstruction,and patients with urinary incontinence were also treated with urethroplasty.The operative time for patients with vaginal hysterectomy was(64.0±4.3)min and the blood loss was(42.0±7.9)ml.The duration of vaginal CY Liu pelvic restoration was(30.0±3.6)min,the blood loss was(20.5±6.2)ml,the postoperative retention of the urinary catheter was(2.6±0.8)d,no postoperative urinary retention occurred,the anal exhaust time was(1.1±0.4)d,the postoperative hospital stay was(5.3±2.5)d.Postoperative sacrococcygeal discomfort occurred in 3 cases,and vulvar sensation,lower limb sensation and muscle tone were all normal,and the pain and discomfort resolved on their own after 5-7 d with symptomatic treatment of physical therapy.At discharge,all of them had normal urine and stool,no fever and hematoma formation,no postoperative infection,and no deviation of the vaginal axis.The mean follow-up period was(6.8±3.6)months,and the subjective and objective cure rates were 100%(30/30).The patients were satisfied with their postoperative quality of sexual life and quality of life.Conclusion Vaginal CY Liu pelvic restoration is an effective,safe,and feasible therapeutic option for pelvic organ prolapse,and worthy of clinical promotion and application.