腹腔镜下腹壁横向悬吊术治疗盆腔脏器脱垂的临床优势评价

Evaluation of Clinical Advantages of Laparoscopic Lateral Abdominal Wall Suspension in the Treatment of Pelvic Organ Prolapse

目的探究盆腔脏器脱垂患者运用腹腔镜下腹壁横向悬吊术的效果。方法随机选取2021年8月-2022年10月临沂市兰山区人民医院妇科收治的80例盆腔脏器脱垂患者为研究对象,按随机数表法分为两组,各40例,对照组行髂耻韧带悬吊术;观察组行腹腔镜下腹壁横向悬吊术,对比两组手术时间、住院时间、术中出血量、盆腔脏器脱垂定量分期(pelvic organ prolapse quantitive examination,POP-Q)情况、并发症发生率与复发率、术后生活质量。结果两组手术时间、住院时间相比,差异无统计学意义(P>0.05),观察组术中出血量多于对照组,差异有统计学意义(P<0.05);手术前两组POP-Q分度相比,差异无统计学意义(P>0.05),手术后,两组POP-Q分度与手术前相比,差异有统计学意义(P<0.05),术后两组POP-Q分度相比,差异有统计学意义(P<0.05);观察组并发症发生率(7.5%)与对照组(0)比较,差异无统计学意义(χ^(2)=3.117,P=0.078);观察组复发率为2.5%,低于对照组的17.5%,差异有统计学意义(χ^(2)=6.300,P=0.012);手术前,两组生活质量评分比较,差异无统计学意义(P>0.05),术后3个月,两组生活质量评分均高于术前,差异有统计学意义(P<0.05),但两组生活质量评分相比,差异无统计学意义(P>0.05)。结论盆腔脏器脱垂患者运用腹腔镜下腹壁横向悬吊术治疗,具有显著的治疗效果,其与髂耻韧带悬吊术相比,可改善盆腔脏器脱垂,减少术后并发症。

Objective To explore the effect of laparoscopic transverse abdominal wall suspension in patients with pelvic organ prolapse.Methods Eighty patients with pelvic organ prolapse admitted to the Department of Gynecology of Linyi Lanshan District People's Hospital from August 2021 to October 2022 were randomly selected as the study objects and divided into two groups with forty cases each according to random number table grouping method.Control group was treated with iliopectineal ligament suspension.Observation group was treated with laparoscopic transverse abdominal wall suspension.Operation time,hospital stays,intraoperative blood loss,pelvic organ prolapse quantitive examination(POP-Q),incidence of complications and recurrence,and postoperative quality of life were compared between the two groups.Results There were no statistically significant differences in operation time and hospital stays between the two groups(P>0.05).The amount of intraoperative bleeding in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in quantitative staging of POP-Q between the two groups before surgery(P>0.05).After surgery,POP-Q grading in the two groups was compared with before surgery,and the difference was statistically significant(P<0.05).Postoperative POP-Q scores were compared between the two groups,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of complications between the observation group(7.5%)and the control group(0)(χ^(2)=3.117,P=0.078).The recurrence rate of the observation group was 2.5%,which was lower than 17.5%of the control group,and the difference was statistically significant(χ^(2)=6.300,P=0.012).Three months after surgery,the quality of life scores in both groups were higher than those before surgery,and the difference was statistically significant(P<0.05).However,there was no statistically significant difference in the quality of life scores between the two groups(P>0.05).Conclusion Laparoscopic abdominal wall transverse suspension has a significant therapeutic effect on patients with pelvic organ prolapse.Compared with iliopubic ligament suspension,it can improve pelvic organ prolapse and reduce postoperative complications.