摘要
目的探讨宫颈穹窿化技术在保留子宫的全盆底重建手术中的应用价值。方法选取2011年1月至2012年1月因患有Ⅲ~Ⅳ度盆腔器官脱垂,于中国医科大学附属盛京医院接受植入网片保留子宫的全盆底重建手术治疗患者109例作为研究对象。其中观察组,保留子宫同时增加＂宫颈穹窿化＂术式的全盆底重建手术,共50例;对照组,保留子宫的传统全盆底重建手术,共59例。两组患者术前一般情况,术前POP-Q分期,围手术期情况比较,差异无统计学意义。结果术后随访POP-Q分期,观察组与对照组C点位置[6个月（-6.75±1.83）cm对（-4.63±1.07）cm,12个月（-6.75±1.83）cm对（-4.03±1.57）cm,18个月（-7.01±1.83）cm对（4.03±1.77）cm]、D点位置[6个月（-7.13±1.41）cm对（-5.00±1.41）cm,12个月（-7.12±1.41）cm对（-4.52±1.51）cm,18个月（-7.13±1.41）cm对（4.02±1.81）cm],差异均有统计学意义（P〈0.05）;观察组阴道总长度（TVL）明显长于对照组[6个月（8.13±0.64）cm对（7.00±0.76）cm,12个月（8.13±0.64）cm对（6.50±0.56）cm,18个月（8.13±0.64）cm对（6.50±0.56）cm;均P〈0.05]。结论通过在保留子宫的盆底重建术中加入＂宫颈穹窿化技术＂提高了宫颈、穹窿位置,延长了阴道长度,最大限度的预防了全盆底重建术后宫颈延长、穹窿脱垂或子宫脱垂等复发情况的发生。
Objective To study the value of cervical vaulation in pelvic reconstruction surgery with uterus reservation.Methods Choose 109 patients who took surgery of pelvic reconstruction with uterus reservation in Shengjing Hospital because of Ⅲ~Ⅳ degree pelvic organ prolapsed from January 2011 to January 2012, and divide them into two groups.Experimental group： 50 patients receiving cervical vaulation in pelvic reconstruction surgery with uterus reservation;Control group： 59 patients receiving traditional pelvic reconstruction surgery with uterus reservation. The general condition, perioperative outcomes and follow up data were compared between two groups. Results 18 months after operation, some parameters are compared, the point C,D is higher in experimental group than in control group[C： 6 months（-6.75±1.83）cm vs（-4.63±1.07）cm,12 months（-6.75±1.83）cm vs（-4.03±1.57）cm,18 months（-7.01±1.83）cm vs（4.03±1.77）cm], [D：6 months（-7.13±1.41）cm vs（-5.00±1.41）cm,12 months（-7.12±1.41）cm vs（-4.52±1.51）cm,18 months（-7.13±1.41）cm vs（4.02±1.81）cm]（P0.05）, and the TVL was longer in experimental group than in control group[6 months（8.13±0.64）cm vs（7.00±0.76）cm,12 months（8.13±0.64）cm vs（6.50±0.56）cm,18 months（8.13±0.64）cm vs（6.50±0.56）cm;P0.05]. Conclusion Cervical vaulation in pelvic reconstruction surgery with uterus reservation can raise the position of cervix and fomix. At the same time,it can extend the length of vagina.So it can maximumy prevent the recurrence of cervical lengthening,vaulation prolapse and uterus prolapse.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2015年第4期327-331,共5页
Chinese Journal of Practical Gynecology and Obstetrics
基金
国家科技部十二五"重大新药创制"科技重大专项课题(2012ZX09401004)
辽宁省科学技术计划项目(2012225017)
中华预防医学会科研资金支持项目(20130606)
关键词
宫颈穹窿化
保留子宫
盆底重建术
盆腔器官脱垂
cervical vaulation
reservation of uterus
pelvic reconstruction surgery
pelvic organ prolapse
