经阴道骶棘韧带悬吊治疗盆腔脏器脱垂的效果及影响因素调查

Curative effect of transvaginal sacrospinous ligament suspension on pelvic organ prolapse and its influencing factors

目的分析经阴道骶棘韧带悬吊术治疗盆腔脏器脱垂(POP)的效果及影响因素。方法回顾性选取2016年4月至2021年4月在黄河三门峡医院就诊的309例POP患者的临床资料。于术前和术后24个月评价手术治疗效果;术后随访24个月,统计POP患者术后复发情况,并根据POP患者术后是否发生复发,将患者分为复发组和非复发组,分析影响POP患者术后复发的危险因素。结果术后,患者治疗效果优于术前(P<0.05);309例POP患者中,有42例术后出现复发,复发率为13.59%。两组患者的年龄、BMI、产次、绝经、盆腔手术史、长期便秘及术前POP-Q分度比较,差异均有统计学意义(P<0.05);而在孕次、高血压、糖尿病、规律性生活比较,差异均无统计学意义(P>0.05)。BMI≥25 kg/m^(2)、绝经、盆腔手术史、长期便秘、术前高POP-Q分度是影响POP患者术后复发的独立危险因素(P<0.05)。结论经阴道骶棘韧带悬吊术治疗POP临床疗效好,但仍有部分患者容易复发,临床需要重点关注BMI≥25 kg/m^(2)、绝经、盆腔手术史、长期便秘、术前高POP-Q分度等类型的患者,预防复发。

Objective To analyze the curative effect of transvaginal sacrospinous ligament suspension on pelvic organ prolapse(POP)and its influencing factors.Methods A retrospective collection was performed on the clinical data of 309 patients with POP in the hospital between April 2016 and April 2021.The results were evaluated before and 24 months after operation.After 24 months of postoperative follow-up,the recurrence of POP patients was analyzed.According to presence or absence of postoperative recurrence,patients were divided into recurrence group and non-recurrence group.The risk factors of postoperative recurrence were analyzed.Results After surgery,curative effect was improved(P<0.05).Among the 309patients with POP,there were 42 cases(13.59%)with postoperative recurrence.There were significant differences in age,BMI,parity,menopause,history of pelvic surgery,long-term constipation and preoperative indexing of pelvic organ prolapse quantitative examination(POP-Q)between the two groups(P<0.05),but there was no significant difference in gravidity,hypertension,diabetes mellitus or regular sexual life(P>0.05).BMI≥25 kg/m^(2),menopause,history of pelvic surgery,longterm constipation and preoperative high POP-Q indexing were independent risk factors of postoperative recurrence in POP patients(P<0.05).Conclusions Transvaginal sacrospinous ligament suspension has good clinical curative effect in POP,but there are still some patients with postoperative recurrence.Clinical attention should be focused on patients with BMI≥25 kg/m^(2),menopause,history of pelvic surgery,long-term constipation and high preoperative POP-Q indexes to prevent recurrence.