腹腔镜下高位骶韧带悬吊术治疗子宫脱垂的疗效探讨

目的评价腹腔镜下高位骶韧带悬吊术治疗子宫脱垂患者的疗效。方法2008年5月至2012年7月在北京大学第三医院因POP—Q分期Ⅱ～Ⅲ期子宫脱垂行腹腔镜下高位骶韧带悬吊术治疗的患者共lO例，以主观症状和POP—Q测量评价患者的主观、客观治愈率、复发率；并以盆底不适调查表短表20（PFDI-20）评价手术前后患者的生活质量；以盆腔器官脱垂一尿失禁性生活问卷31（PISQ-31）评价手术前后患者的性生活质量。结果患者平均年龄51．32岁（47～62岁），术后随访率为100％，平均随访时间为14．91个月（2～51个月）。术后主观、客观治愈率均为100％，无并发症发生。术前、术后6个月生活质量评价PFD卜20评分分别为（51．25±3．22）分和（O．22±0．15）分，术前、术后6个月性生活质量评价PISQ-31评分分别为（64．25±8．34）分和（96．44±8．12）分，两者术前、术后比较，差异均有统计学意义（P〈0．05）。结论腹腔镜下高位骶韧带悬吊术治疗子宫脱垂患者的疗效确切，可明显改善患者的生活质量及性生活质量。

Discussion on the therapeutic effect of laparoscopic high uterosacral ligament suspension in treatment of uterine prolapse

Objective To evaluate the clinical outcome of laparoscopic high uterosaeral ligament suspension in treatment of uterine prolapse. Methods 10 women with uterine prolapsed stage Ⅱ -Ⅲunderwent laparoscopic high uterosacral ligament suspension from May 2008 to July 2012 in Peking University Third Hospital. Pre and postoperative symptoms, pelvic organ prolapse quantitation （POP- Q） stage, pelvic floor distress inventory- short form 20 （PFDI - 20） and prolapse and incontinence sexual function questionnaire 31 （PISQ - 31） measurements were used to assess anatomic outcome, quality of life and sexual life outcome. Results The patients＇ mean age was 51.32 （47-62） years old, the follow-up rate was 100% with a median follow - up time of 14. 91 （2-51） months. Subjective and objective cure rate were both 100% without any complications. PFDI - 20 measurements and scores was 51.25 ±3.22 before surgery and 0. 22t：0. 15 after surgery. PISQ- 31 measurements and scores was 64. 25±8. 34 before surgery and 96. 44±8. 12 after surgery. It reached statistical difference when scores were compared before and after surgeries （P〈0. 05）. Conelnsions Laparoscopie high uterosacral ligament suspension and imt）rove the Quality of life and sexual life with satisfied clinical outcome.