摘要
目的评估自创的保留子宫的全盆底悬吊术在治疗多区域、复杂型的盆腔器官脱垂的有效性和安全性。方法对36例有不同缺陷的女性盆腔器官脱垂患者进行全盆底悬吊术,应用聚丙烯网片对子宫主韧带、骶韧带、阴道前后壁、膀胱宫颈韧带进行全盆底悬吊,并根据国际尿控协会制定的盆腔器官脱垂定量(POP-Q)分度法评价手术效果。合并有压力性尿失禁的患者同时进行改良经闭孔尿道中段无张力悬吊术。结果全盆底悬吊术的手术时间平均为95min,出血量平均为150mL,根据POP-Q分度法,36例患者的子宫脱垂、阴道前后壁膨出等症状全部得到纠正,术后无院内感染发生。未观察到其他与手术相关的并发症。所有患者均在术后2～5d出院。术后随访平均9个月,患者的盆底结构基本正常,相关症状消失或明显改善。结论该全盆底悬吊术是一种能治疗多区域、复杂型盆腔器官脱垂的微创手术。在保留子宫的同时能完成全盆底结构和功能的全部或部分重建。短期疗效稳定,长期疗效有待进一步观察。
[Objective] To explore the feasibility and effectiveness of a modified uterus reserving slingplasty in the treatment of complex female pelvic organs＇ prolapse （POP）. [Method] Thirty-six patients with different defects of pelvic organ prolapse underwent this de-novo slingplasty. The procedures included restoring the position of pro- lapsed pelvic organ by suturing polypropylene mesh to strengthen cardinal ligament, uterosacral ligament, anterior and posterior vaginal wall and plica vesicouterina. POP-Q was used to evaluate all the patients before or after surgery. [Results] The average operating time was 95 minutes and hemorrhage volume was 150 mL. Correction of all the prolapsed pelvic organs was achieved right after surgery. No recurrence was observed after an average of nine months＇ follow-up. [Conclusions] POP could be treated by this new pelvic floor slingplasty without removal of uterus. The short-term results are promising. More clinical trials are needed to evaluate its effectiveness, safety and long-term outcomes.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2008年第13期1867-1869,1872,共4页
China Journal of Modern Medicine
基金
国家自然基金资助项目(No:30471815)
关键词
盆腔器官膨出
子宫脱垂
全盆腔悬吊术
盆底重建
盆底功能障碍性疾病
pelvic organ prolapse
uterine prolapse
female pelvic floor slingplasty
pelvic floor reconstruction
female pelvic floor dysfunction
