腹腔镜下子宫骶骨固定术对盆腔脱垂患者的临床观察

Clinical Observation of Laparoscopic Hysterosacral Fixation in Patients with Pelvic Prolapse

目的:分析盆腔脱垂疾病特点,研究腹腔镜下子宫骶骨固定术对盆腔脱垂患者的临床效果。方法:回顾性分析2018年7月~2019年7月136例盆腔脱垂患者的临床资料,按手术方法分为两组,每组68例,观察组行腹腔镜下子宫骶骨固定术,对照组行改良式全盆底功能重建术,比较两组的手术情况。结果:组间治疗效果比较,观察组手术成功率(95.6%)明显高于对照组(85.3%),P<0.05;组间患者复发情况比较,两组复发率(2.9%,7.4%)比较无统计学意义,P>0.05;组间患者康复情况比较,于术前及术后1年采用盆底功能障碍性疾病症状问卷简表(Pelvic Floor Distress Inventory-Short form 20,PFDI-20)和盆腔脏器脱垂、尿失禁性功能问卷(Prolapse/Urinary Incontinence Sexual Questionnaire-12,PISQ-12)对两组患者进行评估。两组术后PFDI-20评分与PISQ-12评分均较术前明显提高,P<0.05,观察组PFDI-20评分与PISQ-12评分均明显高于对照组,P<0.05;组间患者生活质量以健康调查简表(The MOS Item Short from Health Survey,SF-36)评估,观察组患者生活质量评分明显高于对照组,P<0.05。结论:腹腔镜下子宫骶骨固定术治疗盆腔脱垂,手术成功率高,患者恢复效果好,有助于提升患者生活质量。

Objective:To analyze the characteristics of pelvic prolapse disease and study the clinical effect of laparoscopic uterosacral fixation on patients with pelvic prolapse.Methods:The clinical data of 136 patients with pelvic prolapse from July 2018 to July 2019 were retrospectively analyzed.They were divided into two groups according to surgical methods,with 68 cases in each group.The study group underwent laparoscopic uterosacral fixation and the control group Modified total pelvic floor function reconstruction was performed,and the surgical conditions of the two groups were compared.Results:Compared with the treatment effect between groups,the successful rate of operation in the observation group(95.6%)was significantly higher than that in the control group(85.3%),P<0.05;There was no significant difference in the recurrence rate between the two groups(2.9%,7.4%),P>0.05;The rehabilitation of patients between the two groups was compared.The patients in the two groups were evaluated with the Pelvic Floor Distress Inventory-Short form 20(PFDI-20)and the Prolapse/Urinary Incontinence Sequential Questionnaire-12(PISQ-12)before and 1 year after the operation.The scores of PFDI-20 and PISQ-12 in the observation group were significantly higher than those in the control group(P<0.05);The quality of life of patients in the observation group was significantly higher than that in the control group(P<0.05)according to the MOS Item Short from Health Survey(SF-36).Conclusion:Laparoscopic uterosacral fixation for the treatment of pelvic prolapse has a high success rate and a good recovery effect for patients,which can help improve the quality of life of patients.