阴道前后壁修补术联合阴式子宫全切术治疗中重度子宫脱垂的疗效

目的探究阴道前后壁修补术联合阴式子宫全切术治疗中重度子宫脱垂的疗效及其对性功能的影响。 方法选择芜湖市第五人民医院妇产科自2014年8月至2018年8月收治的中重度子宫脱垂患者60例，随机分为观察组与对照组，每组各30例。观察组行阴式全子宫切除术加阴道前后壁修补术治疗，对照组行单纯阴道前后壁修补术治疗，对比2组围手术期临床指标、术后并发症发生率及复发情况，采用盆腔器官脱垂/尿失禁性功能问卷（PISQ-12）对比2组术前、术后随访6个月的性功能变化情况。 结果观察组平均手术时间、肛门排气时间、住院天数明显短于对照组，观察组术中出血量少于对照组，差异有统计学意义（P<0.05）；观察组术后并发症发生率与对照组差异无统计学意义（P>0.05）；观察组的治愈率为90.00%，好转率为10.00%，高于对照组的80.00%、3.33%，观察组无复发者，对照组复发率为16.67%，差异均有统计学意义（P<0.05）；术后随访6个月后观察组PISQ-12评分为（35.12±3.37）分，低于对照组（38.83±5.62）分，差异有统计学意义（P<0.05）。 结论阴式全子宫切除术联合阴道前后壁修补术治疗中重度子宫脱垂的临床效果较理想，与单纯阴式子宫切除术相比可显著缩短手术时间较短，减少术中出血，提高手术疗效，降低术后复发率，但在改善术后性功能方面并不具有优势。

Effect of repair of anterior and posterior vaginal wall combined with total vaginal hysterectomy on moderate and severe uterine prolapse and its sexual function

ObjectiveTo explore the curative effect of vaginal anterior and posterior wall repair combined with vaginal hysterectomy on moderate and severe uterine prolapse and its influence on sexual function. MethodsFrom August 2014 to August 2018, 60 patients with moderate and severe uterine prolapse who were hospitalized and operated in our hospital were randomly divided into the observation group and the control group, 30 cases in each group. The observation group underwent vaginal hysterectomy plus anterior and posterior vaginal wall repair, and the control group underwent simple anterior and posterior vaginal wall repair. The perioperative clinical indicators, postoperative complications, and recurrence were compared between the two groups. Pelvic organs were used. The prolapse/urinary incontinence sexual function questionnaire (PISQ-12) was used to compare the sexual function of the two groups before and after 6 months of follow-up. ResultsThe average operation time, anal exhaust time, and length of stay in the observation group were significantly shorter than those in the control group. The intraoperative blood loss in the observation group was less than that in the control group (P<0.05). There was no statistical difference (P>0.05); the cure rate in the observation group was 90.00%, and the improvement rate was 10.00%, which was higher than 80.00% and 3.33% in the control group. The recurrence rate in the observation group was 16.67%, which was lower than 0 in the control group. % (P<0.05); the PISQ-12 score of the observation group after the 6-month follow-up was (35.12±3.37) points, which was lower than the control group (38.83±5.62) points (P<0.05). ConclusionThe clinical effect of vaginal hysterectomy combined with repair of anterior and posterior wall of vagina in the treatment of moderate and severe uterine prolapse is ideal. Compared with simple vaginal hysterectomy, it can significantly shorten the operation time, reduce intraoperative bleeding, improve the operation effect and reduce the recurrence rate, but it has no significant advantage in improving the sexual function.