摘要
目的探讨腹腔镜下子宫悬吊术对子宫脱垂患者盆腔器官脱垂定量分期法(POP-Q)分度和性生活质量的影响。方法选取浙江省海宁市中心医院与浙江省人民医院于2013年5月至2018年5月期间收治的100例子宫脱垂患者,按照随机数字表法将所有患者随机分为对照组和试验组,其中对照组患者采取常规的阴式子宫切除术进行治疗,而试验组患者则在腹腔镜下采取子宫颈无张力阴道吊带(TVT)悬吊术治疗。观察两组患者治疗前后的性生活质量和手术相关指标、盆腔器官脱垂定量分度情况及术后并发症的发生情况等。结果两组患者治疗前的POP-Q分度比较并无明显差异(均P>0.05);经过治疗后,两组患者的POP-Q分度情况均显著优于本组治疗前(χ^2值分别为7.438、6.174,均P<0.05),但是两组患者治疗后的POP-Q分度情况并无明显差异(均P>0.05)。两组患者的术后膀胱残余尿量比较并无明显差异(P>0.05)。试验组患者的术中出血量[(44.28±10.99)mL vs.(94.23±11.02)mL]、手术时间[(57.20±10.72) min vs.(69.72±15.44)min]及术后留院时间[(5.73±1.48)d vs.(7.94±2.34)d]均显著低于对照组,差异均有统计学意义(t值分别为17.239、3.485、4.372,均P<0.05)。治疗后,试验组与对照组患者尿失禁性功能量表(PISQ-12)评分均较治疗前提高,而且试验组与对照组比较评分提高,差异均有统计学意义(t值分别为18.498、12.410、6.668,均P<0.05)。试验组患者术后并发症发生率为12.00%,显著低于对照组患者的34.00%,差异有统计学意义(χ^2=5.283,P<0.05)。结论对于子宫脱垂患者,在腹腔镜下采用子宫颈TVT吊带悬吊术进行治疗明显促进了患者阴道解剖结构的恢复,不仅安全性高,还能够有效改善患者的性功能,值得在临床上推广运用。
Objective To investigate the effect of laparoscopic uterine suspension on pelvic organ prolapse quantitation(POP-Q) score and sexual life quality in patients with uterine prolapse.Methods 100 cases of uterine prolapse patients admitted and treated in Haining City Central Hospital and Zhejiang Provincial People’s Hospital from May 2013 to May 2018 were selected.All patients were randomly divided into control group and experimental group according to the random number table method.Patients in the control were treated with regular Yin type hysterectomy,while the experimental group patients were treated with laparoscopic cervical tension-free vaginal tape(TVT) suspension.Before and after treatment,the quality of sexual life,the indicators related to surgery,the quantitative classification of pelvic organ prolapse and the occurrence of postoperative complications were observed and compared.Results There was no significant difference in the degree of POP-Q before treatment between the two groups(all P>0.05).And after treatment,the degree of POP-Q in both groups were significantly better than before treatment(χ^2 values were 7.438 and 6.174,respectively,all P<0.05),but there was no significant difference in POP-Q score between the two groups after treatment(all P>0.05).There was no significant difference in postoperative bladder residual urine between the two groups(P>0.05).And the intraoperative blood loss [(44.28±10.99)mL vs.(94.23±11.02)mL],the operation time[(57.20±10.72)min vs.(69.72±15.44)min]and the postoperative hospital stay[(5.73±1.48)d vs.(7.94±2.34)d]in the experimental group were all significantly lower than those in the control group(t values were 17.239,3.485 and 4.372,respectively,all P<0.05).In addition,after treatment,the score of prolapse/urinary incontinence sexual questionnaire(PISQ-12) in both the two groups were significantly higher than those before treatment(t values were 18.498 and 12.410,respectively,both P<0.05),and the score of PISQ-12 in the experimental group was significantly higher than that in the control group(t=6.668,P<0.05).The incidence of postoperative complications in the experimental group was significantly lower than that in the control group(12.00% vs.34.00%,χ^2=5.283,P<0.05).Conclusion For the patients with uterine prolapse,treatment with laparoscopic cervical TVT suspension significantly promotes the recovery of vaginal anatomical structure,which is not only safe,but also can effectively improve the patients’ sexual function of the patients that can be worth popularizing in clinic.
作者
阮国海
沈鹤萍
郝秋芬
陈锡琴
RUAN Guohai;SHEN Heping;HAO Qiufen;CHEN Xiqin(Department of Gynecology,Haining Central Hospital,Zhejiang HaiNing 314408,China;Department of Gynecology,Zhejiang Provincial People’s Hospital,Zhejiang HangZhou 310026,China)
出处
《中国妇幼健康研究》
2019年第12期1608-1611,共4页
Chinese Journal of Woman and Child Health Research
关键词
子宫脱垂
子宫悬吊术
腹腔镜
性生活质量
descensus uteri
laparohysteropexy
laparoscope
sexual life quality
