周愛龍 萬玉珍

[摘要] 目的 探討改良式陰腹聯(lián)合子宮骶骨固定術治療子宮脫垂的效果。 方法 選擇2019年1月至2020年5月江西省婦幼保健院進行治療的40例患者納入本研究。按照抽取法隨機分為兩組，每組各20例。對照組采用腹腔鏡下子宮骶骨固定術，觀察組采用改良式陰腹聯(lián)合子宮骶骨固定術。觀察兩組手術時間、術中出血量、并發(fā)癥、手術滿意度、盆底功能癥狀評分、性生活滿意度評分。 結果 與對照組相比，觀察組手術時間較短，術中出血量較少，差異有統(tǒng)計學意義（P<0.05）;觀察組并發(fā)癥總發(fā)生率明顯低于對照組，差異有統(tǒng)計學意義（P<0.05）;觀察組手術滿意度明顯高于對照組，差異有統(tǒng)計學意義（P<0.05）;干預前兩組PFDI-20、POP、排便癥狀、排尿癥狀評分比較，差異無統(tǒng)計學意義（P>0.05）;干預后觀察組PFDI-20、POP、排便癥狀、排尿癥狀評分高于干預前和對照組，差異有統(tǒng)計學意義（P<0.05）;對照組干預后PFDI-20、POP、排便癥狀、排尿癥狀評分高于干預前，差異有統(tǒng)計學意義（P<0.05）;干預前兩組PISQ-12、PGI-C評分比較，差異無統(tǒng)計學意義（P>0.05）;干預后觀察組PISQ-12、PGI-C評分高于干預前和對照組，差異有統(tǒng)計學意義（P<0.05）;干預后對照組PISQ-12、PGI-C評分高于干預前，差異有統(tǒng)計學意義（P<0.05）。 結論 改良式陰腹聯(lián)合子宮骶骨固定術治療子宮脫垂效果較好，可以縮短手術時間、減少術中出血量，降低并發(fā)癥的發(fā)生，提高手術滿意度，改善盆底功能癥狀評分、性生活滿意度評分，應用價值較高。

[關鍵詞] 改良式;腹腔鏡;子宮;骶骨固定;子宮脫垂;效果

[中圖分類號] R711.74? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）24-0086-04

Evaluation of the effect of modified vaginal abdomen combined with uterosacral fixation in the treatment of uterine prolapse

ZHOU Ailong? ?WAN Yuzhen

Department of Obstetrics and Gynecology， Jiangxi Maternity and Child Health Hospital， Nanchang? ?330006， China

[Abstract] Objective To explore the effect of modified vaginal abdomen combined with uterosacral fixation in the treatment of uterine prolapse. Methods A total of 40 patients who were treated in Jiangxi Maternity and Child Health Hospital from January 2019 to May 2020 were selected for this study. According to the extraction method， they were randomly divided into two groups， with 20 cases in each group. The control group underwent laparoscopic uterosacral fixation. The observation group underwent a modified vaginal abdomen combined with uterosacral fixation. The operation time， intraoperative blood loss， complications， surgical satisfaction， pelvic floor function symptom score， and sexual satisfaction score were observed. Results Compared with the control group， the operation time in the observation group was shorter， and intraoperative blood loss was less， and the difference between the groups was significant （P<0.05）. The total complication rate in the observation group was lower than that in the control group， and the difference between the groups was significant （P<0.05）. The surgical satisfaction in the observation group was higher than that in the control group， and the difference between the groups was significant （P<0.05）.? There was no significant difference in the scores of PFDI-20， POP， bowel symptoms， and urination symptoms between the observation group and the control group before intervention（P>0.05）. The scores of PFDI-20， POP， bowel symptoms， and urination symptoms in the observation group after intervention were higher than those before the intervention and the control group， and the differences were significant（P<0.05）. The scores of PFDI-20， POP， bowel symptoms， and urination symptoms in the control group were significantly higher than those before the intervention， and the differences were significant（P<0.05）. There was no significant difference in PISQ-12 and PGI-C scores between the observation group and the control group before intervention（P>0.05）. The PISQ-12 and PGI-C scores in the observation group after the intervention were higher than those before the intervention and the control group， and the differences were significant（P<0.05）. The PISQ-12 and PGI-C scores in the control group after the intervention were higher than those before the intervention， and the difference was significant（P<0.05）. Conclusion Modified vaginal abdomen combined with uterosacral fixation is effective in treating uterine prolapse， which can shorten the operation time， reduce intraoperative blood loss， reduce complications， increase surgical satisfaction， improve pelvic floor function symptom score， and sexual life satisfaction degree score. It has a high application value.