探讨经阴道坐骨棘筋膜固定缝合术治疗盆底器官功能障碍的效果评价

目的探讨经阴道坐骨棘筋膜固定缝合术(ischial spinous fascia fixation)治疗子宫脱垂患者的有效性和安全性。方法对2010年3月至2016年1月在佛山市妇幼保健院完成生育的子宫脱垂患者28例,实施经阴道坐骨棘筋膜固定术,采用POP-Q评分评估手术治疗效果。结果 28例患者中,22例患者为子宫脱垂Ⅲ度,6例为症状性脱垂Ⅱ度;术中出血量(50±10.5)m L,手术时间(60±8.6)mim,术后住院时间(4.2±0.8)d,术后随访时间均为24个月。术前患者子宫C点(+2.60±0.20)cm和D点(-3.91±0.61)cm;术后患者C点(-5.67±0.60)cm,D点(-6.00±0.30)cm;3例患者术后失访,28例患者中22例患者术后3月均有正常性生活,2例患者因担心术后复发,拒绝性生活;1例术后有不适感觉拒绝性生活。结论经阴道坐骨棘筋膜固定缝合术是利用自身组织治疗子宫脱垂,具有操作简单、治愈率高、复发率低、费用低,安全微创、术后对性生活影响小等优点,是安全有效的手术方式。

The clinical effect assessment of transvaginal ischial spinous fascia fixation in treating pelvic organ prolapse

Objective To study the safety and effectiveness of transvaginal ischial spinous fascia fixation in treating patients with uterine prolapse .Methods To study the clinical data of 28 patients after fertility with uterine prolapse in Foshan Women and Children Healthcare Hospital from March 2010 to January 2016,they were carried out transvaginal ischial spinous fascia fixation ,using POP-Q to assess operational outcomes .Results In 28 patients,22 patients were with uterine prolapse of degree Ⅲ and 6 patients were of degreeⅡ.The amount of bleeding during operation were (50 ±10.5)mL;the operational time was(60 ±8.6)mim;the time in hospital after operation was(4.2 ±0.81)d;Following-up time after operation were 24 months.Before operation, the C point was at(+2.60 ±0.20)cm and D point at(-3.91 ±0.61)cm;After operation,the C point was at(-5.67 ±0.60)cm, and D point was at( -6.00 ±0.30)cm .After operation,3 patients lost follow -up,22 patients had normal sexual life 3 months after operation, 2 cases refused sexual life for worrying about recurrence ;1 patient refused sexual life for discomfort .Conclusion Transvaginal ischial spinous fascia fixation are safe and efficient operation for the patients with uterine prolapse by using autologous tissue .With its simplicity, high cure rate, low recurrence rate, low cost, minimally invasion and small influence for sex ,the operation are worth of further promotion and application.