改良阴式子宫切除联合阴道前后壁修补术在治疗盆底器官脱垂中应用价值.docVIP

改良阴式子宫切除联合阴道前后壁修补术在治疗盆底器官脱垂中应用价值 　　[摘要] 目的 探讨传统阴式子宫切除联合阴道前后壁修补术经改良后在治疗盆底器官脱垂（POP）中的临床价值。方法 回顾性分析2012年1月～2016年12月我院因POP行改良阴式子宫切除联合阴道前后壁修补术56例患者的临床资料，比较手术前后POP定量分期（POP-Q）各指示点位置，评价客观治愈率，通过术后随访问卷调查，评价主观治愈率，并对手术创伤、并发症等进行分析。 结果 56例POP皆顺利完成手术治疗，无重大并发症发生，50例术前术后POP-Q各指示点Aa、Ba、Ap、Bp、C、gh、pb比较差异均有统计学意义（P0.05），客观治愈率88.0%（44/50），主观治愈率94.6%（53/56），性生活满意度96.1%（49/51），排尿情况得到不同程度改善。 结论 改良阴式子宫切除联合阴道前后壁修补术在治疗POP中最符合微创观念，手术治愈率高，患者满意度高，并发症少，有很高的临床应用价值。 　　[关键词] 盆底器官脱垂；经阴道子宫切除术；尿失禁；阴道壁膨出 　　[中图分类号] R713 [文献标识码] B [文章编号] 1673-9701（2017）15-0059-04 　　[Abstract] Objective To explore the clinical value of modified vaginal hysterectomy combined with vaginal anterior and posterior wall repair in the treatment of pelvic organ prolapse（POP）. Methods The clinical data of 56 patients with modified vaginal hysterectomy combined with vaginal anterior and posterior wall repair because of POP were analyzed retrospectively from January 2012 to December 2016. Each indicator point position of POP quantitative staging（POP-Q） before and after surgery was compared， and the objective cure rate was evaluated. The subjective cure rate was evaluated through follow-up questionnaire survey. And the surgical trauma， complications were analyzed. Results 56 cases of POP successfully completed surgical treatment， with no major complications occurred. And there were statistically significant differences of 50 cases in preoperative and postoperative POP-Q indicators including Aa， Ba， Ap， Bp， C， gh， pb（P0.05）. The objective cure rate was 88.0%（44/50）， and the subjective cure rate was 94.6%（53/56）. The sexual satisfaction was 96.1%（49/51）， and the urination situation was improved to varying degrees. Conclusion Modified vaginal hysterectomy combined with vaginal anterior and posterior wall repair in the treatment of POP is the most consistent with the minimally invasive concept with high cure rate， high patient satisfaction and less complications， which has high clinical value. 　　[Key words] Pelvic organ prolapse； Tra