改良阴式骶棘韧带固定术治疗女性盆腔脏器脱垂的效果研究

Effect of modified transvaginal sacrospinal ligament fixation in treatment of female patients with pelvic organ prolapse

  • 摘要: 目的 观察改良阴式骶棘韧带固定术治疗女性盆腔脏器脱垂的临床效果。 方法 将60例子宫脱垂和阴道穹隆脱垂患者按手术方式分为对照组和研究组,每组30例。对照组采用改良阴道前壁桥式修补术联合阴道后壁桥式修补术,研究组在对照组基础上采用改良阴式骶棘韧带固定术。术后随访0.5、1.0、3.0年,比较2组围术期指标、盆腔脏器脱垂定量分期法(POP-Q)结果以及盆底功能障碍性疾病症状问卷(PFDI-20)、盆腔脏器脱垂性生活质量问卷-12(PISQ-12)、盆底功能障碍影响简易问卷(PFIQ-7)评分。 结果 研究组手术时间、术中出血量、术后疼痛评分、住院时间、住院费用均优于对照组,但差异无统计学意义(P>0.05)。2组患者术后0.5、1.0、3.0年POP-Q分期结果均较术前改变,差异有统计学意义(P<0.05)。2组患者术后0.5、1.0、3.0年PFDI-20、PFIQ-7均较术前降低, PISQ-12较术前升高,且研究组术后0.5、1.0、3.0年PFDI-20、PFIQ-7均低于对照组, PISQ-12高于对照组,差异有统计学意义(P<0.05)。 结论 改良阴式骶棘韧带固定术具有较好的临床效果,能显著改善盆腔脏器脱垂患者生活质量,减轻患者焦虑、抑郁情绪。

     

    Abstract: Objective To observe the clinical effect of modified transvaginal sacrospinal ligament fixation in the treatment of female patients with pelvic organ prolapse. Methods Totally 60 patients with uterine prolapse and vaginal vault prolapse were divided into control group and study group according to the operation modes, with 30 cases in each group. The control group was treated with modified anterior vaginal wall bridge repair combined with posterior vaginal wall bridge repair, and the study group was treated with modified transvaginal sacrospinal ligament fixation on the basis of the control group. The patients were followed up for 0.5 year, 1.0 year and 3.0 years. The perioperative indexes, results of Quantitative Staging of Pelvic Organ Prolapse(POP-Q), and scores of Pelvic Floor Distress Inventory-Short Form 20(PFDI-20), Pelvic Organ Prolapse Questionnaire-12 for Quality of Life(PISQ-12)and Pelvic Floor Impact Questionnaire-Short Form 7(PFIQ-7)were compared between the two groups. Results The operation time, intraoperative blood loss, postoperative pain score, length of hospital stay and hospitalization expenses of the study group were better than those of the control group, but there were no significant differences between two groups(P>0.05). The results of POP-Q at 0.5 year, 1.0 year and 3.0 years after operation were significantly changed compared with those before operation(P<0.05). Scores of PFDI-20 and PFIQ-7 at 0.5 year, 1.0 year and 3.0 years after operation in both groups were significantly lower than those before operation, while PISQ-12 was significantly higher than that before operation, and PFDI-20, PFIQ-7 and PISQ-12 in study group were significantly better than those in control group at 0.5 year, 1.0 year and 3.0 years after operation(P<0.05). Conclusion Modified transvaginal sacrospinal ligament fixation can significantly improve the - quality of life and reduce the anxiety and depression in patients with pelvic organ prolapse.

     

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