改良双侧骶棘韧带固定术治疗盆腔脏器脱垂的效果研究

Effect of improved bilateral sacrospinous ligament fixation in treatment of pelvic organ prolapse

  • 摘要: 目的 比较改良阴式双侧骶棘韧带固定术与腹腔镜阴道骶骨固定术治疗盆腔脏器脱垂(POP)的疗效。 方法 将60例 POP 患者随机分为研究组(改良阴式双侧骶棘韧带固定术)和对照组(腹腔镜阴道骶骨固定术),每组30例。比较2组手术时间、术中出血量、术后疼痛评分、住院时间、住院费用、临床效果。随访6个月,比较2组盆底功能障碍性疾病症状问卷(PFDI-20)、盆腔器官脱垂性生活质量问卷-12(PISQ-12)评分。 结果 研究组手术时间、术中出血量、术后疼痛评分、住院费用短于、低于对照组,差异均有统计学意义(P<0.05)。2组患者术后6个月POP-Q分度测量值均较术前降低,差异有统计学意义(P<0.05); 2组术后6个月POP-Q分度测量值比较,差异无统计学意义(P>0.05)。2组患者术后PFDI-20评分较术前降低, PISQ-12较术前升高,差异有统计学意义(P<0.05)。2组术后并发症发生情况比较,差异无统计学意义(P>0.05)。 结论 改良阴式双侧骶棘韧带固定术的治疗效果较好,具有操作简单、手术时间短、恢复快等优势,可减轻患者的经济负担。

     

    Abstract: Objective To compare clinical effect of improved bilateral sacrospinous ligament fixation and laparoscopic vaginal sacral fixation in treatment of female pelvic organ prolapse(POP). Methods Sixty patients with POP were randomly divided into study group(n=30)and control group(n=30). The study group was treated with improved bilateral sacral spine ligament fixation, while the control group was treated with laparoscopic vaginal sacral fixation. Operation time, bleeding volume, postoperative Visual Analogue Scale(VAS)score, hospitalization time, hospitalization cost, and clinical effect were observed. After follow-up for six months, the scores of Pelvic Floor Dysfunction Disease Symptom Questionnaire(PFDI-20)and Pelvic Organ Prolapse Sexual Quality Questionnaire(PISQ-12)were compared between the two groups. Results The operative time, bleeding volume, postoperative VAS score, hospitalization time and hospitalization cost of the study group were significantly lower or shorter than those of the control group(P<0.05). Pop-Q values of patients in both groups significantly decreased at 6 months after surgery when compared with those before surgery(P<0.05). The POP-Q values 6 months after operation between the two groups showed no statistically significant differences(P>0.05). Postoperative PFDI-20 scores after treatment in two groups were significantly lower, and PISQ-12 score was significantly increased than those before surgery(P<0.05). The incidence rates of postoperative complications in the two groups showed no significant differences(P>0.05). Conclusion Modified transvaginal sacrospinous ligament fixation has better therapeutic effect as well as advantages of simple operation, short operation time and quick recovery, and can relieve the economic burden of patients.

     

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