| 圆韧带联合骶韧带悬吊预防子宫切除术后盆底功能障碍的效果 |
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| 引用本文： | 李娟,修晨,牛翠丽,陈晓琳,王卓,张志革. 圆韧带联合骶韧带悬吊预防子宫切除术后盆底功能障碍的效果[J]. 蚌埠医学院学报, 2023, 48(3): 349-353. DOI: 10.13898/j.cnki.issn.1000-2200.2023.03.016 |
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| 作者姓名： | 李娟 修晨 牛翠丽 陈晓琳 王卓 张志革 |
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| 作者单位： | 河北省邢台市第三医院 妇科, 054000 |
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| 基金项目： | 河北省医学科学研究课题项目20201564 |
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| 摘 要： | 目的：探讨圆韧带联合骶韧带悬吊预防子宫切除术后盆底功能障碍的效果及子宫切除术后发生盆底功能障碍的危险因素。方法：选取100例因子宫肌瘤、子宫腺肌病需行全子宫切除术的病人作为研究对象，随机分为观察组与对照组，各50例。对照组行常规腹腔镜全子宫切除术，观察组病人在对照组基础上行圆韧带联合骶韧带悬吊。比较2组病人手术情况(手术时间及出血量)、盆底功能障碍相关情况[盆腔器官脱垂定量系统(POP-Q)评分、盆底疾病生活影响问卷简易版7(PFIQ-7)评分及盆底器官脱垂/盆底器官脱垂/尿失禁对性功能影响的调查问卷(PISQ-12)评分]。分析子宫切除术后发生盆底功能障碍的危险因素和保护因素。结果：2组病人手术出血量及手术并发症差异均无统计学意义(P>0.05),观察组手术时间长于对照组(P<0.05)。2组术后6个月POPQ评分差异无统计学意义(P>0.05);观察组术后12个月Bb点(阴道前壁脱出距处女膜最远点)、C点(前穹隆或阴道残端距处女膜点)和Bp点(阴道后壁脱出距处女膜最远点)POPQ评分均明显高于对照组(P<0.01)。2组术前PFIQ-7评分差异无统计学意义(...
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| 关 键 词： | 盆底功能障碍 圆韧带联合骶韧带悬吊 生活质量 |
| 收稿时间： | 2020-09-10 |
Effect of round ligament combined with uterosacral ligament suspension in preventing pelvic floor dysfunction after hysterectomy |
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| Affiliation: | Department of Gynecology, The Third Hospital of Xingtai, Xingtai Hebei 054000, China |
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| Abstract: | ObjectiveTo investigate the effect of round ligament combined with uterosacral ligament suspension in preventing pelvic floor dysfunction after hysterectomy, and the risk factors of pelvic floor dysfunction after hysterectomy.MethodsOne hundred patients undergoing total hysterectomy due to uterine fibroids and adenomyosis were selected as the research subjects, and randomly divided into experimental group and control group, with 50 cases in each group.The patients in the control group underwent conventional laparoscopic total hysterectomy, and the patients in the experimental group underwent round ligament combined with uterosacral ligament suspension on the basis of the control group.The operation conditions(including operation time and blood loss), pelvic floor dysfunction-related conditions [including pelvic organ prolapse quantification(POP-Q) score, pelvic floor impact questionnaire-7(PFIQ-7) score, and pelvic organ prolapse/urinary incontinence sexual questionnaire-12(PISQ-12) score] were compared between the two groups.The risk factors and protective factors of pelvic floor dysfunction after hysterectomy were analyzed.ResultsThere was no significant difference in operative blood loss and operative complications between the two groups(P>0.05), and the operation time in the experimental group was longer than that in the control group(P < 0.05).There was no significant difference in POPQ scores between the two groups at 6 months after operation(P>0.05).The POPQ scores at point Bb(the farthest point from the anterior vaginal wall to the hymen), point C(the point in the anterior fornix of vagina or vaginal stump), and point Bp(the point in the posterior vaginal prolapse, farthest from hymen) in the experimental group at 12 months after operation were significantly higher than those in the control group(P < 0.01).There was no significant difference in PFIQ-7 scores between the two groups before operation(P>0.05), and the PFIQ-7 scores in the experimental group at 6 months and 12 months after operation were significantly lower than those in the control group(P < 0.01).There was no significant difference in PISQ-12 scores in the two groups between before and after treatment(P>0.05).Pelvic floor dysfunction was found in 6 cases(12%) in the experimental group and in 15 cases(30%) in the control group, and the incidence of pelvic floor dysfunction in the experimental group was lower than that in the control group(χ2=4.88, P < 0.05).Univariate analysis showed that the proportion of patients with age >50 years, parity >2 times, without round ligament suspension and without early pelvic floor exercise in patients with pelvic floor dysfunction was higher than that of patients without pelvic floor function(P < 0.05 to P < 0.01).Multivariate analysis showed that age, parity and no early pelvic floor exercise were the risk factors for postoperative pelvic floor dysfunction(P < 0.05), and round ligament suspension was a protective factor(P < 0.01).ConclusionsRound ligament combined with uterosacral ligament suspension can reduce the incidence of pelvic floor dysfunction after hysterectomy, and age >50 years old, parity >2 times and no early pelvic floor exercise are the risk factors of pelvic floor dysfunction after hysterectomy. |
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