骶棘韧带联合圆韧带悬吊术预防子宫切除患者盆腔脏器脱垂的应用

Application of sacrospinal ligament combined with round ligament suspension surgery to prevent pelvic organ prolapse in patients undergoing hysterectomy

目的探讨骶棘韧带联合圆韧带悬吊术预防子宫切除患者盆腔脏器脱垂的临床应用价值。方法选取2020年1月至2021年6月高安市妇幼保健院收治的70例子宫切除并盆腔脏器脱垂患者作为研究对象,按照随机数字表法分为对照组与研究组,每组35例。对照组实施常规腹腔镜下全子宫切除术,研究组在对照组基础上采用骶棘韧带联合圆韧带悬吊术。比较两组手术情况(手术时间、术中出血量)、术后复发情况、生命质量[盆底障碍影响简易问卷(PFIQ-7)、性生活质量问卷(PISQ-12)评分]。结果研究组手术时间长于对照组,差异有统计学意义(P<0.05),但两组术中出血量比较差异无统计学意义。研究组术后3、6个月复发率均低于对照组,但差异无统计学意义。术后6个月,研究组PFIQ-7评分低于对照组,PISQ-12评分高于对照组,差异有统计学意义(P<0.05)。结论骶棘韧带联合圆韧带悬吊术能较好地减轻及预防子宫切除患者盆腔脏器脱垂情况,提高患者生命质量及性生活质量,具有一定临床应用价值。

Objective To explore the clinical application value of sacrospinal ligament combined with round ligament suspensionin surgery to prevent pelvic organ prolapse in patients undergoing hysterectomy.Methods 70 patients with hysterectomy and revent pelvic organ prolapse admitted to Gao'an Maternal and Child Health Hospital from January 2020 to June 2021 were selected as the study subjects,and they were divided into the control group and the study group according to random number table method,with 35 cases in each group.The control group underwent routine laparoscopic total hysterectomy,and the study group underwent sacrospinal ligament combined with round ligament suspensionin surgery on the basis of the control group.The operation conditions(operation time,intraoperative blood loss),postoperative recurrence,and quality of life(pelvic floor impact questionnaire-7[PFIQ-7]and patient-initiated sexual questionnaire-12[PISQ-12]scores)were compared between the two groups.Results The operation time in the study group was longer than that in the control group,the difference was statistically significant(P<0.05),but there was no significant difference in the amount of intraoperative blood loss between the two groups.The recurrence rate 3,6 months after operation in the study group were lower than those in the control group,but the differences were no significant difference.6 months after operation,the PFIQ-7 score in the study group was lower than that in the control group,and the PISQ-12 score was higher than that in the control group,the differences were statistically significant(P<0.05).Conclusion Sacrospinal ligament combined with round ligament suspension surgery can effectively alleviate and prevent pelvic organ prolapse in patients undergoing hysterectomy,improve the quality of life and sexual life of patient,and has certain clinical application value.