腹壁自体筋膜盆底悬吊术治疗盆底器官脱垂40例

目的探讨腹壁自体筋膜盆底悬吊术治疗盆底器官脱垂的临床疗效和应用价值。方法对40例经腹壁自体筋膜盆底悬吊术治疗的盆底器官脱垂患者进行回顾性分析，术后1个月门诊随访，了解术后近期情况，以后每半年随访1次，随访1年。结果40例患者腹壁自体筋膜盆底悬吊术均在全麻下进行，整体手术时间平均为（133.41±56.57）min（含妇科其他操作，如子宫切除术、卵巢囊肿剥除术、阴道后壁修补术等，单独行盆底悬吊术2例），平均失血量为（109.71±70.71）mL，术后平均住院时间为（8.94±0.71）d，其中2例因腹部切口液化，术后尿管保留时间为（4.26±1.41）d，其中1例术中膀胱损伤，术后保留导尿14 d。随访1年，2例术后阴道后壁膨出。生活质量未受影响。结论腹壁自体筋膜盆底悬吊术是一种治疗子宫阴道脱垂的简单、有效、容易掌握的手术方式，可以进行临床术式的推广。

Clinical analysis of 40 cases of pelvic floor dysfunction treated by abdominal autologous fascia pelvic floor suspension

Objective To investigate the value,efficacy and safety of abdominal autologous fascia pelvic floor suspension,as a new method of treating pelvic floor dysfunction. Methods Forty cases with pelvic floor dysfunction underwent abdominal autologous fascia pelvic floor suspension. All patients had clinical symptoms. Regular follow - up was provided once after discharged one month later,then per 6 months,and one years in all. Results All patients successfully completed their operations. The average operative time was(133. 41 ± 56. 57)min(including other gynecological operations,such as hysterectomy,ovarian cystectomy,posterior colporrhaphy). Only two cases were performed with the new method alone,and the estimated blood loss was(109. 71 ± 70. 71)mL. The overall hospital stay averaged was (8. 94 ± 0. 71)days,during which 2 patients extended hospitalizations because of fat liquefaction. Catheter remained averaged(4. 26 ± 1. 41)days,in which 1 case had the urinary bladder injury during surgery. Patients were followed up for one years,and only 2 cases had the same clinical symptom,douglascele. Quality of life for all patients was as normal as before. Conclusion Abdominal autologous fascia pelvic floor suspension is a safe,efficient and easy surgery in the management of pelvic floor dysfunction,which is worth popularizing widely.