腹腔镜辅助盆底重建术治疗子宫脱垂的临床疗效分析

目的探讨腹腔镜下子宫次全切除（laparoscopic supracervical hysterectomy,LSH）并子宫圆韧带悬吊加宫骶韧带缩短术治疗子宫脱垂的临床疗效。方法选取2005年6月至2009年6月收治的子宫脱垂患者18例为研究组,行LSH联合圆韧带悬吊和子宫骶韧带缩短术重建盆底;随机选取子宫脱垂患者30例为对照组,行传统阴式子宫切除加阴道前后壁修补术。比较术中术后的并发症,并随访手术后阴道穹隆脱垂和性生活等情况。结果所有手术均顺利进行且在随访时间内临床症状均减轻或消失,性生活恢复正常。研究组阴道穹隆脱垂率减少,性生活满意度增加,差异有统计学意义（P〈0.05）;手术并发症和泌尿系异常情况差异无统计学意义（P〉0.05）。结论 LSH术并行圆韧带悬吊加子宫骶韧带缩短术是治疗子宫脱垂重建盆底的一种疗效好、创伤小的治疗方式,患者耐受性好,近期疗效明显。

Clinical effect of pelvic reconstruction assisted with Laparoscopic technique for the uterine proplase

Objective To study the effect of laparoscopic supracervical hysterectomy（LSH）combined with ligamentum teres uteri suspension and uterosacral ligament resection for the uterine proplase.Methods Eighteen inpatients were given LSH combined ligamentum teres uteri suspension and uterosacral ligament resection for the uterine proplase in study group from June,2005 to June,2009 and 30 cases randomly selected from inpatients were given vaginal hysterectomy and anterior and posterior vaginal wall colporrhaphy in control group.The intra-operative and post-operative complications were compared between two groups.The situation of vaginal fornix proplase and sexual life were followed up.Results All surgeries were carried on successfully and the clinical symptoms reduced or disappeared in following-up,the sexual life recovered.The prolapsed rate of Vaginal fornix reduced and sex life satisfactory degree increased in study group that the difference was significance between two groups（P0.05）.The difference of the post-operative complications and urinary system was no significance between two groups（P0.05）.Conclusion LSH combined ligamentum teres uteri suspension and uterosacral ligament resection is effective,minimally invasive and more favorable for the uterine proplase and reconsrtrctive pelvic floor.