腹腔镜下阴道骶骨固定术治疗盆腔器官脱垂的临床效果

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Abstract Objective To investigate the efficacy and satisfaction of laparoscopic sacral colpopexy in patients with pelvic organ prolapse.Methods A total of 47 patients with severe uterine prolapse(stage POP-QⅢ-Ⅳ)confirmed by POP-Q staging from January 2014 to September 2016 in Dalian Maternal and Child Health Care Hospital and underwent laparoscopic sacral colpopexy were selected,POP-Q staging,PFD symptom questionnaire (PFDI-20)and influence questionnaire (PFIQ-7)were used to evaluate the symptoms and quality of life of the pelvic floor at 6 months after the operation.Results All patients were followed up within six months after surgery.Only 1 case had recurrent vaginal anterior wall prolapse(POP-QⅡ),the recurrence rate was 2.12%(1/47);and 3 cases were newly diagnosed with urinary incontinence,the incidence rate was 8.57%(3/35);2 patients were newly frequency of frequent urination,the incidence rate was 6.25% (2/32).1 case was troubled by dysuria,the rate was 2.7% (1/37),and the incidence rate for constipation was 22.2% (1/45).There were 1 cases of new chronic pelvic pain,the incidence of which was 2.13% (1/47).In the POP-Q staging,the median of anatomical locations of Aa,Ba,C,Ap and Bp were restored from 1.0,3.0,2.0,－3.0,－2.0 cm before operation to －3.0,－3.0,－6.0,－3.0 and －3.0 cm after operation,which were significantly lower than that before operation(P=0.00).The length of the perineal body(Pb)was significantly increased,compared with before operation(P=0.00),genital hiatus length shortened significantly（P=0.00),but there was no significant change in the total length of the vagina(P=0.16).The median scores of questionnaire of PFIQ-7 and PFDI-20 were reduced from 70.38 points and 71.43 points preoperatively to 0.00 points and 9.52 points postoperatively,the difference was statistically significant(P=0.00).The total score of PFIQ-7 was higher than that of PFDI-20 after operation,the scores of POPDI-6,POPIQ-7,UDI-6 and UIQ-7 after operation of the two groups were significantly lower than those before operation(P=0.00),there was no significant difference in the CARDI-8 and CARIQ-7 scores between before and after operation.Conclusion Laparoscopic sacral colpopexy is an effective method for the treatment of pelvic prolapse,the surgical trauma and complications are less,it can keep the original length of the vagina and prevent the recurrence of vaginal fornix prolapse.

Key words： Pelvic organ prolapse Laparoscopic sacral colpopexy Quality of life questionnaire Complication

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	GAO Hang
	HOU Jia-yu
	DENG Yan-jie

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GAO Hang,HOU Jia-yu,DENG Yan-jie. Clinical effect of laparoscopic sacral colpopexy in the treatment of pelvic organ prolapse[J]. 中国当代医药, 2018, 25(8): 17-20.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2018/V25/I8/17

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