腹腔镜子宫阴道骶骨固定术治疗中盆腔缺陷的临床效果研究

Clinical Study on Laparoscopic Hysterovaginal Sacral Fixation for Pelvic Defects

目的探讨腹腔镜子宫阴道骶骨固定术治疗中盆腔缺陷的临床效果。方法将2021年1月—2023年6月在本院妇科治疗的46例中重度盆腔器官脱垂(UP)患者作为研究对象,随机将其分为两组,每组23例。对照组使用阴式子宫切除+阴道壁修补术,观察组使用腹腔镜子宫阴道骶骨固定术,对比两组的各项手术指标、尿流动力学指标、盆底功能,并分析上述指标对患者性生活质量和生活质量的影响等。结果观察组手术时间、术中出血量与对照组相当(P>0.05),但术后留置尿管时间、住院时间少于对照组(P<0.05);观察组术后最大尿流率、平均尿流率、最大膀胱容量均大于对照组,残余尿量少于对照组(P<0.05);观察组术后PFDI-20评分低于对照组,PISQ-12评分、I-QOL评分高于对照组(P<0.05)。结论腹腔镜子宫阴道骶骨固定术治疗中盆腔缺陷的临床效果显著,能有效改善和加固盆底结构,恢复盆底及泌尿系统功能,提高患者生活质量。

Objective To explore clinical study of laparoscopic hysterovaginal sacral fixation for pelvic defects.Methods The paper chose 46 patients with moderate to severe pelvic organ prolapse in gynecology department of our hospital from January 2021 to June 2023,and divided them into two groups randomly.Control group was treated with vaginal hysterectomy and vaginal wall repair,while observation group with laparoscopic uterovaginal sacral fixation.Surgical indicators,urodynamics and other indicators were compared between two groups.Results Surgical time and intraoperative blood loss in observation group was comparable to control group(P>0.05),postoperative indwelling catheter time and length of stay was shorter than control group(P<0.05).Maximum postoperative urine flow rate,average urine flow rate and maximum bladder capacity of observation group was higher than control group,while residual urine volume was lower than control group(P<0.05).Postoperative PFIQ-7 scores in observation group were lower than control group,while PISQ-12 scores and I-QOL scores were higher than control group(P<0.05).Conclusion Laparoscopic hysterovaginal sacral fixation can achieve significant clinical effect for pelvic defects,can improve and reinforce pelvic floor structure,restore pelvic floor and urinary system function and improve life quality of patients effectively.