改良腹腔镜子宫悬吊术治疗子宫脱垂效果分析

目的分析改良腹腔镜子宫悬吊术治疗子宫脱垂的效果。方法对32例子宫脱垂患者实施改良腹腔镜子宫悬吊术,观察治疗效果和安全性。结果 32例患者均顺利完成手术。手术时间(42.08±7.90)min,术中出血量(705.20±12.36)mL,术后住院时间(6.10±1.40)d。出院后均获12个月随访,3例患者自述腹壁有牵拉不适感,2例患者出现尿频。均未进一步处理,1～2个月内自行缓解。未发生感染、网片侵蚀、网片暴露及血肿形成等并发症。末次随访,盆腔脏器脱垂分度(POP-Q分期法)明显优于术前,差异有统计学意义(P0.05)。结论改良腹腔镜子宫悬吊术治疗子宫脱垂,创伤小、治愈率高、复发率低,安全可靠。     

腹腔镜下圆韧带悬吊术治疗子宫脱垂的临床疗效

目的 分析腹腔镜下圆韧带悬吊术治疗子宫脱垂的临床疗效。方法 收集2019年3月至2021年12月期间在本院就诊的子宫脱垂患者62例的临床资料，根据患者接受手术方式的不同分为对照组（采取阴式子宫切除）和实验组（采取阴道残端高位骶韧带联合圆韧带悬吊术）各31例。观察患者的术中出血量，手术持续时间，住院时间和住院费用。观察患者的术前和术后的术前PFIQ-7评分，术后的子宫脱垂的复发情况和术后的复发时间。观察患者术后的并发症发生情况。结果 两组患者在术中出血量、手术持续时间和住院费用比较中没有差异，P>0.05；而实验组患者的住院时间显著低于对照组，差异有统计学意义，P<0.05。实验组患者在随访期内有4例复发，术后复发间隔时间为10±2.22月，两组患者在术前PFIQ-7评分比较中没有差异性，P>0.05；而术后PFIQ-7评分实验组显著低于对照组，差异有统计学意义，P<0.05。两组患者术后的总并发症发生情况比较，实验组患者的并发症发生情况显著低于对照组，差异有统计学意义，P<0.05。结论 腹腔镜圆韧带悬吊术治疗子宫脱垂能够复位患者的盆底器官的毗邻关系，提升...     

腹腔镜下保留子宫网片子宫悬吊术治疗子宫膀胱脱垂的配合

对15例子宫膀胱脱垂患者行腹腔镜保留子宫自膨式单丝聚丙烯网片子宫悬吊术,结果手术效果均满意,15例患者脱垂症状得到改善,无并发症发生。提出术前准确评估患者子宫及膀胱脱垂程度,加强心理护理和健康教育,协助摆放过截石位"Z"型体位,术中巡回护士及器械护士密切配合和全面护理是手术成功的关键。     

腹腔镜经腹膜外子宫悬吊术治疗子宫脱垂效果观察

目的观察腹腔镜腹膜外子宫悬吊术治疗子宫脱垂的效果。方法随机将2017-03—2018-01间唐河县人民医院收治的72例子宫脱垂患者分为2组,各36例。对照组行经阴道全子宫切除术,观察组行腹膜外子宫悬吊术。结果观察组治疗总有效率、住院指标、术后PISQ-12评分及并发症发生率均优于对照组,差异有统计学意义(P0.05)。结论腹腔镜经腹膜外子宫悬吊术治疗子宫脱垂,可有效降低术中出血量,缩短手术时间,降低并发症发生率,促进患者术后康复。     

腹壁自体筋膜盆底悬吊术与腹腔镜下子宫颈悬吊术治疗盆底器官脱垂的疗效观察

目的:探讨腹壁自体筋膜盆底悬吊术与腹腔镜下子宫颈悬吊术治疗盆底器官脱垂的临床应用价值及对生活质量的影响。方法:将60例盆底器官脱垂患者随机分为观察组与对照组,每组30例,观察组行腹壁自体筋膜盆底悬吊术,对照组行腹腔镜下子宫颈悬吊术,应用盆腔器官脱垂定量分度法评估手术效果。术后6个月采用盆底功能障碍问卷短表对患者生活质量进行调查,采用盆腔器官脱垂尿失禁性功能问卷对患者性生活质量进行调查。结果:观察组手术时间[(72.32±8.34)min]、术中出血量[(57.43±8.52)ml]、尿管留置时间[(3.23±0.54)d]、术后住院时间[(7.32±0.69)d]均多于对照组[(53.34±6.88)min、(45.65±7.43)ml、(2.39±0.87)d、(6.27±0.75)d],差异有统计学意义(P0.01),术后两组Aa、Ba、C、D、Ap、Bp等指示点位置术后均较术前明显上升,其中观察组上升水平明显高于对照组,更接近解剖学位置(P0.01),盆底功能障碍问卷、排便功能障碍问卷及泌尿功能障碍问卷评分观察组明显低于对照组,盆腔器官脱垂尿失禁性功能问卷中情感、生理、总分等观察组均高于对照组(P0.05)。结论:腹壁自体筋膜盆底悬吊术与腹腔镜下子宫颈悬吊术在治疗盆底器官脱垂中均具有良好的临床治疗效果,其中腹壁自体筋膜盆底悬吊术治疗盆底器官脱垂恢复盆底器官解剖更理想,对患者术后生活质量影响较小。     

腹腔镜下阴道残端腹壁悬吊术联合阴道前后壁修补术治疗重度子宫脱垂的疗效观察

目的:探讨腹腔镜下阴道残端腹壁悬吊术联合阴道前后壁修补术治疗重度子宫脱垂的临床效果.方法:回顾分析2017年12月至2019年12月63例重度子宫脱垂(Ⅲ度)患者的手术资料,其中30例行阴道前后壁修补术(A组),33例行腹腔镜下阴道残端腹壁悬吊术联合阴道前后壁修补术(B组).对比分析两组手术指标、不同时点阴道残端水平、...     

改良腹腔镜子宫悬吊术治疗子宫脱垂20例报告

目的:探讨改良腹腔镜子宫悬吊术的临床效果。方法:回顾分析2012年6月至2013年7月为20例子宫脱垂患者行改良腹腔镜子宫悬吊术的临床资料。记录患者术后2、6、12个月的后期疗效。结果:20例患者均成功完成手术,手术时间60~135 min,平均(98±25)min;术中出血量30~80 ml,平均(65±12)ml;术后患者使用导尿管的时间平均(3.0±1.5)d;术后住院4~6 d,平均(4.5±0.5)d。术后患者盆底康复情况良好,性生活均得到明显改善。术后2~12个月子宫均恢复至正常位置,无脱垂现象。结论:改良腹腔镜子宫悬吊术安全、疗效确切、花费低、创伤小、术后疼痛轻、住院时间短、术后康复快,保留了子宫,且更好地保留了阴道功能,值得推广应用。     

腹腔镜下子宫悬吊术治疗盆腔器官脱垂对患者生活质量的影响

目的 研究盆腔器官脱垂患者应用腹腔镜下子宫悬吊术对生活质量的影响。方法 回顾性分析2019年1月至2021年6月本院收治的104例盆腔器官脱垂患者，依据患者是否保留子宫意愿将其分为甲组（56例）、乙组（48例），其中甲组接受腹腔镜子宫悬吊术（LUS），乙组接受阴式全子宫切除术+骶韧带悬吊术。比较两组的手术效果、生活质量、并发症、复发率、再手术率。结果 经分析，两组治疗后的盆腔器官脱垂度分级、拔除尿管时间、并发症发生率、1年内再手术率相比无差异（P>0.05）；相比于乙组，甲组术中出血量少，手术用时及住院时间短，1年内复发率低（P<0.05）；治疗后，相比于乙组，甲组的盆底功能障碍问卷（PFDI-20）、全身状况改善问卷（PGI-I）、盆底障碍影响简易问卷-7(PFIQ-7)评分低，盆腔脏器脱垂/尿失禁性功能问卷（PISQ-12）评分高（P<0.05）。结论 LUS相比于阴式子宫全切术明显改善了手术效果，提高了生活质量，且1年内的复发率低，对于有保留子宫意愿的患者属于更优的选择。     

经腹悬吊治疗老年妇女子宫脱垂

为探讨用腹直肌前鞘制成筋膜条经腹悬吊治疗老年性妇女子宫脱垂的疗效,对14例患有子宫脱垂的老年妇女,将其腹直肌前鞘游离出一条约(3～4) cm×1 cm的筋膜条,经腹将脱垂的子宫悬吊固定.手术平均时间22 min,出血少,无副损伤发生.术后1年随诊11例无复发.认为经腹悬吊治疗老年妇女子宫脱垂方法简单,出血少,恢复快,手术疗效肯定.     

腹腔镜子宫悬吊联合阴道后壁修补治疗子宫脱垂合并肠疝的临床分析

目的探究采用腹腔镜子宫悬吊联合阴道后壁修补术对子宫脱垂患者并合并肠疝的治疗效果。 方法选取2019年7月至2020年4月于马鞍山市中医院治疗子宫脱垂并发肠疝的女性患者68例纳入研究对象。按照治疗方法的不同将患者分为试验组和对照组,每组患者34例。试验组采用腹腔镜子宫悬吊联合阴道后壁修补治疗,对照组采用阴式子宫切除术联合阴道后壁修补治疗,比较2组患者手术一般情况、术后盆底肌功能、手术成功率和术后并发症。 结果试验组术中出血量、手术时间、住院时间均低于对照组（P<0.05）。试验组手术成功率为100%（34/34）高于对照组82.35%（28/34）（P<0.05）。治疗后,2组患者盆底功能障碍评分表-20（PFDI-20）、盆底功能障碍影响问卷-7（PFIQ-7）评分均比治疗前降低（P<0.05）,且试验组均低于对照组（P<0.05）。治疗后,2组患者生活满意度量表（SWLS）评分均上升,试验组SWLS评分高于对照组（P<0.05）;治疗后2组患者焦虑自评量表（SAS）评分均下降,试验组SAS评分低于对照组（P<0.05）。试验组并发症发生率为2.94%（1/34）低于对照组的20.59%（7/34）,差异有统计学意义（P<0.05）。 结论腹腔镜子宫悬吊联合阴道后壁修补术对子宫脱垂并发肠疝患者的临床效果更好,显著提升了患者盆底肌功能,不良反应少,安全性高。     

Laparoscopic uterosacral ligament uterine suspension compared with vaginal hysterectomy with vaginal vault suspension for uterovaginal prolapse

This study compares the outcomes of laparoscopic uterosacral ligament uterine suspension (LUSUS) to those of vaginal vault suspension with total vaginal hysterectomy (TVH) for the treatment of symptomatic uterovaginal prolapse. We compared the outcomes of 25 LUSUS to those of 25 TVH with vaginal vault suspension among age-matched controls. No significant complications occurred in either group. EBL and hospitalization duration were significantly less in LUSUS patients (72 cc vs. 227 cc, P < .0001 and 1.05 vs. 1.65 days, P = .002). Vault support, as measured by postoperative pelvic organ prolapse quantitation system point D in the LUSUS group and point C in the TVH group, was better for the LUSUS group (D = –9 vs. C = –7.6, P = .002). No LUSUS group patient underwent reoperation for recurrent apical prolapse as compared to three TVH patients. LUSUS is an effective treatment for appropriately selected women with uterovaginal prolapse who desire uterine preservation     

Laparoscopic sacral suture hysteropexy for uterine prolapse

This study aims to describe and review a new method of uterine conservation in pelvic reconstruction for women with uterine prolapse. This is a prospective study of women who have undergone laparoscopic sacral suture hysteropexy. Structured questions, visual analogue patient satisfaction score (VAS), and vaginal examination were undertaken. Follow-up was performed by non-surgical reviewers. From July 2001 until August 2003, a total of 81 women underwent laparoscopic sacral suture hysteropexy for uterine prolapse. At a mean of 20.3 months follow-up, 76 women (93.8%) were available for questioning and 57 (70.3%) attended for examination. Sixty-five women (87.8%) had no symptoms of pelvic floor prolapse, 54 women (94.7%) had no objective evidence of uterine prolapse, and 61 women (82.4%) were satisfied with their surgery (VAS≥80%). Laparoscopic sacral suture hysteropexy attaches the posterior cervix to the sacral promontory via the right uterosacral ligament. Follow-up data of laparoscopic sacral suture hysteropexy indicate it to be an effective method in the management of uterine prolapse.     

Analysis of risk factors associated with surgical failure of sacrospinous suspension for uterine or vaginal vault prolapse

The goal of this study was to analyze the potential risk factors determining surgical failure after sacrospinous suspension for uterine or vaginal vault prolapse. Each woman underwent a detailed history taking and a vaginal examination before treatment. Follow-up evaluations were at immediate post-operation, 1 week, 1 to 3 months, 6 months, 9 months, and annually after the operation. The surgical failure rate (27/168) following sacrospinous suspension was 16.1%. Using multivariable logistic regression, women with the presence of C or D point stage I at immediate post-operation were a significant risk factor for surgical failure after sacrospinous suspension (odds ratio, 35.34; 95% confidence interval, 8.75–162.75; p < 0.001). The success rate during the 18-month follow-up decreased significantly in women with the presence of C or D point stage I at immediate post-operation than stage 0. Although the sample size of women with symptomatic uterine or vaginal vault prolapse is small, impaired correction of anatomic defects is a significant risk factor for surgical failure of sacrospinous suspension.     

米非司酮治疗子宫肌瘤51例临床疗效分析

目的探讨米非司酮治疗子宫肌瘤51例的临床疗效。方法选择2011年4月～2013年4月确诊为子宫肌瘤的患者51例,给予口服米非司酮治疗。超声检测子宫及子宫肌瘤的大小,实验室检测血清激素水平,观察服药后的不良反应等。结果经过一段时间的治疗后肌瘤缩小明显（P〈0.05）;经过治疗后LH、E2、FSH、P指标明显下降有统计学意义（P〈0.05）,但是催乳素（PRL）下降不明显（P〉0.05）。本次临床观察51例患者中随访到49例患者,随访率为96.1%。其中30例患者在1个月内恢复月经,10例患者在2个月内恢复月经,还有4例患者在半年后恢复月经。随访的所有患者当中瘤体没有增大的有40例占81.6%,瘤体增大的有5例,经手术切除瘤体的有3例,还有1例患者行子宫全切术。结论米非司酮治疗子宫肌瘤效果好,不良反应少,有积极的临床价值。     

Total hysterectomy and anterior vaginal wall suspension for concurrent uterine and bladder prolapses: Long-term anatomical results of additional vault and/or posterior compartment prolapse repair

ObjectiveTo review the long-term results of an intraoperative decision to repair or not repair associated vault and posterior compartment defects after total hysterectomy (TH) and anterior vaginal wall suspension (AVWS) for uterine and bladder prolapses.MethodsAfter gaining Institutional Review Board approval, the operative records of women receiving TH and AVWS concurrently with a minimum follow-up period of 6 months were reviewed. Two groups were identified: Group 1 (G1) underwent TH + AVWS and intraoperative apical and/or posterior repairs, and Group 2 (G2) had TH + AVWS alone. The definition of prolapse recurrence was Pelvic Organ Prolapse—Quantification ≥ Stage 2 and/or any reoperation for prolapse.ResultsFrom 1998 to 2009, a total of 94 women were evaluated. At the mean 3 years follow-up, the rates of overall prolapse recurrence following initial surgeries between G1 and G2 were 30% and 24%, respectively. Additional operative repair for G1 and G2 was 18.5% and 16%, respectively. The progression rate for both groups was < 8%. The overall success for G1 and G2 was 70% and 76%, respectively.ConclusionAt long-term follow-up, nearly one in five apical recurrences in these two surgical groups was observed with stable results in the anterior compartment. The posterior compartment required the least surgical intervention.     

阴式子宫切除加阴道前后壁修补术治疗子宫脱垂20例临床分析

目的探讨阴式子宫切除联合阴道前后壁修补术治疗子宫脱垂的效果。方法对2011-01-2013-06间20例宫脱垂合并阴道前后壁膨出患者行阴式子宫切除联合阴道前后壁修补术。结果平均手术时间(78±17)min,平均术中失血量(77±23)mL,术后住院时间(8.2±1.0)d。20例患者术后症状全部消失,无并发症发生。结论阴式子宫切除联合阴道前后壁修补术是治疗子宫脱垂的安全、有效手段。