腹腔镜子宫悬吊术联合阴道前后壁修补术治疗子宫脱垂合并阴道前后壁膨出患者的效果

Effects of laparoscopic uterine suspension combined with anterior and posterior vaginal wall repair in treatment of patients with uterine prolapse complicated with anterior and posterior vaginal wall prolapse

目的:观察腹腔镜子宫悬吊术联合阴道前后壁修补术治疗子宫脱垂合并阴道前后壁膨出患者的效果。方法:选取2020年4月至2022年4月该院收治的66例子宫脱垂合并阴道前后壁膨出患者进行前瞻性研究,按照随机数字表法分为研究组与对照组各33例。对照组采用传统阴式子宫切除术联合阴道前后壁修补术治疗,研究组采用腹腔镜子宫悬吊术联合阴道前后壁修补术治疗,比较两组手术时间、术中出血量、术后导尿管留置时间、住院时间、阴道肌电压、阴道动态压力和并发症发生率。结果:研究组手术时间和住院时间短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05);术后6个月,两组阴道肌电压和阴道动态压力均高于术前,且研究组高于对照组,差异有统计学意义(P<0.05);两组导尿管留置时间和并发症发生率比较,差异无统计学意义(P>0.05)。结论:腹腔镜子宫悬吊术联合阴道前后壁修补术治疗子宫脱垂合并阴道前后壁膨出患者可提高术后阴道肌电压和阴道动态压力,减少术中出血量,缩短手术时间和住院时间,效果优于阴式子宫切除术联合阴道前后壁修补术治疗。

Objective:To observe effects of laparoscopic uterine suspension combined with anterior and posterior vaginal wall repair in treatment of patients with uterine prolapse complicated with anterior and posterior vaginal wall prolapse.Methods:A prospective study was conducted on 66 patients with uterine prolapse complicated with anterior and posterior vaginal wall prolapse admitted to the hospital from April 2020 to April 2022.They were divided into study group and control group according to the random number table method,33 cases in each group.The control group was treated with traditional vaginal hysterectomy combined with anterior and posterior vaginal wall repair,while the study group was treated with laparoscopic uterine suspension combined with anterior and posterior vaginal wall repair.The operation time,the intraoperative blood loss,the postoperative catheter indwelling time,the hospitalization time,the vaginal muscle voltage,the vaginal dynamic pressure,and the incidence of complications were compared between the two groups.Results:The operation time and the hospitalization time of the study group were shorter than those of the control group,the intraoperative blood loss was lower than that of the control group,and the differences were statistically significant(P<0.05).6 months after the operation,the vaginal muscle voltage and the vaginal dynamic pressure in the two groups were higher than those before the operation,those in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).However,there were no significant differences in the catheter indwelling time and the incidences of complications between the two groups(P>0.05).Conclusions:Laparoscopic uterine suspension combined with anterior and posterior vaginal wall repair in the treatment of uterine prolapse combined with anterior and posterior vaginal wall prolapse can improve the postoperative vaginal muscle voltage and the vaginal dynamic pressure,reduce the intraoperative blood loss,and shorten the operation time and the hospitalization time.Moreover,it is superior to vaginal hysterectomy combined with anterior and posterior vaginal wall repair.