[1]黄武*,杨志英,蔡容,等.基于骶棘韧带/尾骨肌复合体的腹腔镜子宫骶韧带加固固定术治疗盆腔器官脱垂的临床观察[J].中国计划生育和妇产科,2019,(9):31-35.
 HUANG Wu*,YANG Zhi-ying,CAI Rong,et al.Clinical observation of laparoscopic uterine ligament reconstruction based on sacrospinous ligament/tail muscle complex for pelvic organ prolapsed[J].Chinese Journal of Family Planning & Gynecotokology,2019,(9):31-35.
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基于骶棘韧带/尾骨肌复合体的腹腔镜子宫骶韧带加固固定术治疗盆腔器官脱垂的临床观察
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2019年9期
页码:
31-35
栏目:
论著与临床
出版日期:
2019-09-25

文章信息/Info

Title:
Clinical observation of laparoscopic uterine ligament reconstruction based on sacrospinous ligament/tail muscle complex for pelvic organ prolapsed
作者:
黄武*杨志英蔡容兰祥波陈诚张艳丽方志江
成都市郫都区人民医院妇产科
Author(s):
HUANG Wu* YANG Zhi-ying CAI Rong LAN Xiang-bo CHEN Cheng ZHANG Yan-li FANG Zhi-jiang
Department of Obstetrics and Gynecology,Pidu District People's Hospital,Chengdu Sichuan 611730, P.R.China
关键词:
盆腔器官脱垂腹腔镜子宫韧带加固固定术骶棘韧带/尾骨肌复合体经阴道骶棘韧带固定术
Keywords:
pelvic organ prolapselaparoscopic uterine ligament fixationsacrospinous ligament /coccygeus complextransvaginal sacrospinous ligament fixation
分类号:
R 71123
摘要:
目的探讨基于骶棘韧带/尾骨肌复合体的腹腔镜子宫韧带加固固定术治疗盆腔器官脱垂(pelvic organ prolapse,POP)的临床价值。 方法选择2016年7月至2018年9月成都市郫都区人民医院收治的100例POP患者,按随机数字表法分为对照组与观察组各50例,对照组采用经阴道骶棘韧带固定术(sacrospinous ligament fixation,SSLF),观察组采用以骶棘韧带/尾骨肌复合体为锚定点的腹腔镜子宫骶韧带加固固定术,观察两组手术一般情况(手术时间、术中出血量、术后排气时间、住院时间、手术并发症),手术前后均测定残余尿量、最大尿流率、最大膀胱测压容量,并进行 POP 定量分期(Pelvic Organ Prolapse Quantitation,POP-Q),采用盆腔障碍性疾病问卷(Pelvic Floor Distress Inventory Short Form 20,PFDI-20)及性功能问卷表(Prolapse and Incontinence Sexual Function Questionnaire-12,PISQ-12)评定盆腔功能及性生活的变化。结果① 观察组手术时间长于对照组,手术并发症发生率低于对照组,差异有统计学意义(P<005)。② 术前,两组残余尿量、最大尿流率、最大膀胱测压容量比较,差异无统计学意义(P>005);术后6个月,两组上述指标均改善,且观察组优于对照组,差异有统计学意义(P<005)。③ 术前,两组PFDI-20表各维度评分、PISQ-12表评分比较,差异无统计学意义(P>005),术后6个月,两组PFDI-20表各维度评分均降低、PISQ-12表评分上升,观察组PFDI-20表评分低于对照组,PISQ-12表评分高于对照组,差异均有统计学意义(P<005)。 结论基于骶棘韧带/尾骨肌复合体的腹腔镜子宫韧带加固固定术治疗 POP 疗效肯定,可改善患者排尿功能、盆腔功能障碍,优化性生活质量,且并发症少,安全性高。
Abstract:
ObjectiveTo explore the clinical value of laparoscopic uterine ligament fixation based on sacrospinous ligament/coccygeus complex in the treatment of pelvic organ prolapse (POP).Methods150 patients with POP who were admitted to Pidu District People's Hosp

参考文献/References:

[1]吴伟英,方梓羽,马艳群,等.经阴道子宫切除术,阴道壁修补术联合腹腔镜骶棘韧带固定术治疗盆腔器官脱垂 [J].山东医药,2018,58(19):45-47. [2]LEE R K, MOTTRIE A, PAYNE C K, et al. A review of the current status of laparoscopic and robot-assisted sacrocolpopexy for pelvic organ prolapse [J]. European Urology, 2014, 65 (6): 1128-1137. [3]陈敬华,洪莉,蒋敏.改良骶棘韧带固定术与高位宫骶韧带悬吊术治疗中年女性盆腔脱垂的疗效 [J].临床和实验医学杂志,2018,17(23):2524-2527. [4]刘建和,张劲松,方克伟,等.改良腹腔镜下网片宫颈-骶前韧带固定术治疗子宫颈延长伴子宫脱垂的疗效及安全性 [J].中华泌尿外科杂志,2016,37(11):846-850. [5]SEO J T, KIM J M. Pelvic organ support and prevalence by Pelvic Organ Prolapse-Quantification(POP-Q)in Korean women [J]. The Journal of Urology, 2006, 175 (5): 1769-1772. [6]TELEMAN P, STENZELIUS K, IORIZZO L, et al. Validation of the Swedish short forms of the Pelvic Floor Impact Questionnaire (PFIQ-7), Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) [J]. Acta Obstetriciaet Gynecologica Scandinavica, 2011, 90 (5): 483-487. [7]KIM S R, MOON Y J, KIM S K, et al. Changes in sexual function and comparison of questionnaires following surgery for pelvic organ prolapse [J]. Yonsei Medical Journal, 2014, 55 (1): 170-177. [8]SU Z-j, ZHU L, LANG J-h, et al. Proteomic analysis of the uterosacral ligament in postmenopausal women with and without pelvic organ prolapse [J]. Chinese Medical Journal, 2015, 128 (23): 3191-3196. [9]范颖,于新平,邢琛,等.腹腔镜阴道骶前固定术19例报告 [J].中国微创外科杂志,2015,15(4):301-304. [10]LU Ye, CHEN Hua-yun, WANG Xiao-qing, et al. Correlations Between Mitofusin 2 Expression in Fibroblasts and Pelvic Organ Prolapse: An In vitro Study [J]. Chinese Medical Journal, 2017, 130 (24): 2951-2959. [11]苗娅莉,孙秀丽,杨欣,等.腹腔镜阴道骶骨固定术治疗盆腔器官脱垂的疗效评价 [J].实用妇产科杂志,2017,33(2):105-109. [12]CHONG Wo-ojin, FANTL J A, DONOVAN M A. BETA-3 ADRENOCEPTOR EXPRESSION IN THE UTEROSACRAL LIGAMENT IN THE POSTMENOPAUSAL WOMEN WITH PELVIC ORGAN PROLAPSE [J]. Neurourology and Urodynamics, 2018, 37 (1): S542. [13]丁慧,舒慧敏,樊晶,等.经阴道改良骶棘韧带固定术治疗盆腔器官脱垂的临床分析 [J].中国妇幼保健,2017,32(18):4548-4550. [14]WEINTRAUB A Y, NEUMAN M, REUVEN Y, et al. Efficacy and safety of skeletonized mesh implants for advanced pelvic organ prolapse: 12-month follow-up [J]. World Journal of Urology, 2016, 34 (10): 1491-1498. [15]任常,宋晓晨,朱兰,等.应用常规手术器械行骶棘韧带固定术治疗Ⅲ-Ⅳ度盆腔器官脱垂的前瞻性研究 [J].中华妇产科杂志,2017,52(6):369-373. [16]舒慧敏,杨宾烈,陈华,等.前盆底重建术联合骶棘韧带固定术与全盆底重建术治疗重度盆底器官脱垂的疗效分析 [J].现代妇产科进展,2018,27(9):665-668. [17]SCHOTT S, REISENAUER C, BUSCH C. Presence of relaxin-2, oxytocin and their receptors in uterosacral ligaments of pre-menopausal patients with and without pelvic organ prolapse [J]. Acta Obstetricia et Gynecologica Scandinavica, 2014, 93 (10): 991-996. [18]韦玮,陈心秋,贺红英,等.经利用网片的前盆底重建术治疗重度盆腔器官脱垂的临床疗效 [J].现代生物医学进展,2017,17(10):1957-1959. [19]陈海英.改良阴式骶棘韧带固定术治疗妇科盆底重建患者临床分析 [J].海南医学,2015,26(13):1979-1981. [20]陈坤,王婷,陈继明.阴道旁修补联合骶棘韧带固定术治疗阴道前壁脱垂疗效观察 [J].中国性科学,2016,25(3):54-56.

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备注/Memo

备注/Memo:
四川省医学科研课题项目(项目编号:S18081)
更新日期/Last Update: 2019-09-25