腹腔镜辅助子宫切除及骶主韧带断端圆韧带断端悬吊治疗子宫脱垂的疗效探讨.docVIP

精品论文 参考文献 腹腔镜辅助子宫切除及骶主韧带断端圆韧带断端悬吊治疗子宫脱垂的疗效探讨 刘艳霞 李留霞通讯作者 张颖 李灵燕 赵艳红（郑州大学第一附属医院450052） 　　【摘要】目的：探讨腹腔镜辅助子宫切除+骶主韧带断端圆韧带断端悬吊治疗POP-QⅡ-Ⅲ度子宫脱垂的方法及疗效。方法：采用腹腔镜辅助下阴式子宫切除+ 骶主韧带断端圆韧带断端悬吊治疗子宫脱垂患者1 50 例，平均年龄59.1 岁，均为经产妇。150 例患者中Ⅱ度80 例，Ⅲ度70例，合并阴道前壁脱垂120 例（I 度36例、Ⅱ度76 例、Ⅲ度8 例），合并阴道后壁脱垂54 例（I 度30例，Ⅱ度24 例），张力性尿失禁9例。术中同时行阴道前壁修补术84例，后壁修补术24例，尿道中段无张力悬吊术9 例。结果：150例均由同一主刀成功完成手术，平均手术时间91.1min，平均失血量45.7ml，术后随诊6-12 月，阴道顶端均在坐骨棘水平上下1cm 之内，临床治愈好转率1 00%，无近期复发病例。结论：腹腔镜骶主韧带断端圆韧带断端悬吊术是治疗POP-QⅡ-Ⅲ度子宫脱垂简单有效的方法，值得推广应用。 　　【关键词】腹腔镜；子宫脱垂；骶主韧带；圆韧带断端；悬吊【中图分类号】R2 【文献标号】A 【文章编号】2095-7165（2015）10-0001-02The possibility and effect of laparoscopic assisted transvaginal hysterectomy combinedwith suspension surgery on the cardinal and uterosacal ligament stub-end at the stub-endof round ligament in the treatment of uterine prolapse.abstract:Objective: To investigate possibility and effect of laparoscopic assisted transvaginal hysterectomy combined with suspension surgery on thecardinal and uterosacal ligament stub-end at the stub-end of round ligament in the treatment of POP-Q Ⅱ-Ⅲdeg;uterine prolapse. Methods: 150women underwent laparoscopic assisted transvaginal hysterectomy combined with suspension surgery on the cardinal and uterosacal ligament stub-end atthe stub-end of round ligament. The mean age was 59.1years old. All patients were multipara and with uterine prolapse.80 patients were with prolapse ofPOP-Q Ⅱdeg;and 70 were POP-Q Ⅲdeg;. 120 patients were with prolapse of anterior wall of vagina（Ideg;：76，Ⅱdeg;：36，Ⅲdeg;：8）, 54 with posterior wallof vagina（Ideg;：30，Ⅱdeg;：24）. 9 with stress urinary incontinence. 84 patients underwent anterior colporrhaphy, 24 underwent anterior and posteriorcolporrhaphy,9 underwent Tension free Vaginal Tape (TVT). Results: All procedures were successfully completed and were done by one doctor. Themean operating time was 91.1min, and the mean blood loss was 45.7ml. After a mean follow-up of 6-12 months, the top of vaginas were at the level ofischial spine, up and down not more th