腹腔镜下圆韧带缩短及阴道残端悬吊预防子宫切除术后阴道顶端脱垂的临床效果及意义分析

Clinical Effect and Significance Analysis of Laparoscopic Round Ligament Shortening and Vaginal Stump Suspension in Preventing Vaginal Apex Prolapse after Hysterectomy

目的分析研究腹腔镜下圆韧带缩短及阴道残端悬吊预防子宫切除术后阴道顶端脱垂的临床效果及意义。方法随机选择梅州市妇幼保健院2019年1月—2021年8月接收的60例各种原因行全子宫切除术患者为研究对象,分为对照组30例(常规治疗)和观察组30例(腹腔镜下圆韧带缩短及阴道残端悬吊),对比两组患者手术效果、各项临床指标、阴道长度、并发症发生率。结果观察组总有效率(96.7%)高于对照组总有效率(73.3%),差异有统计学意义(χ^(2)=4.706,P<0.05)。两组术中出血量和排气时间对比,差异无统计学意义(P>0.05)。观察组手术时间、住院时间长于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率(3.3%)低于对照组并发症发生率(26.7%),差异有统计学意义(χ^(2)=4.706,P<0.05)。观察组前臂阴道长度(8.85±3.85)cm和后壁阴道长度(10.69±4.53)cm长于对照组,差异有统计学意义(P<0.05)。结论实施腹腔镜下圆韧带缩短及阴道残端悬吊方法,对各种原因行全子宫切除术患者具有降低并发症发生率、提高生活质量的效果,且提高手术成功率,很大程度上提高了预防效果。

Objective To analyze and study the clinical effect and significance of laparoscopic round ligament shortening and vaginal stump suspension in preventing vaginal apex prolapse after hysterectomy.Methods A total of 60 patients who underwent total hysterectomy for various reasons received by Meizhou Maternal and Child Health Hospital from January 2019 to August 2021 were randomly selected as the research objects,and they were divided into 30 cases in the control group(conventional treatment)and 30 cases in the observation group(shortening of the round ligament and suspension of the vaginal stump under laparoscopy).The surgical effect,various clinical indicators,vaginal length,and incidence of complications were compared between the two groups.Results The total effective rate of the observation group(96.7%)was higher than that of the control group(73.3%),the difference was statistically significant(χ^(2)=4.706,P<0.05).There was no statistically significant difference in intraoperative bleeding volume and exhaust time between the two groups(P>0.05).The observation group had longer surgical and hospitalization times than the control group,the difference was statistically significant(P<0.05).The incidence of complications in the observation group(3.3%)was lower than that in the control group(26.7%),the difference was statistically significant(χ^(2)=4.706,P<0.05).The forearm vaginal length(8.85±3.85)cm and posterior wall vaginal length(10.69±4.53)cm in the observation group were longer than those in the control group,with statistically significant differences(P<0.05).Conclusion The implementation of laparoscopic round ligament shortening and vaginal stump suspension can reduce the incidence of complications,improve the quality of life,and increase the success rate of surgery for patients undergoing total hysterectomy for various reasons.The preventive effect has been greatly improved.