阴式子宫切除术联合阴道前后壁修补术对子宫脱垂合并阴道壁膨出患者术后疼痛及复发的影响

目的探讨阴式子宫切除术联合阴道前后壁修补术对子宫脱垂合并阴道壁膨出患者术后疼痛及复发的影响。 方法选取2017年1月到2019年1月，安徽省马鞍山市中心医院收治的90例子宫脱垂合并阴道壁膨出患者。采用随机数字表法将其分为对照组和观察组。对照组45例采用单纯阴道前后壁修补术进行治疗，观察组45例采用阴式子宫切除术联合阴道前后壁修补术进行治疗，2组术后随访1年。比较2组治疗后的临床疗效及手术前后视觉模拟评分（VAS）；统计2组围手术期手术相关指标及并发症发生率和随访1年的复发率。采用SPSS 21.0统计软件进行数据分析。 结果观察组总有效率为93.33%，显著高于对照组的71.11%，差异有统计学意义（P<0.05）。与手术前相比，术后3～7 d，2组VAS评分均呈逐渐降低趋势，且术后3、7 d观察组显著低于对照组，差异有统计学意义（P<0.05）。与对照组相比，观察组术中出血量明显较少，差异有统计学意义（P<0.05）；观察组的住院时间、肛门排气时间、手术时间等明显较短，差异有统计学意义（P<0.05）。观察组并发症发生率、随访1年复发率分别为6.67%、2.22%，显著低于对照组的26.67%、24.44%，差异有统计学意义（P<0.05）。 结论阴式子宫切除术联合阴道前后壁修补术治疗子宫脱垂合并阴道壁膨出，可显著改善患者围手术期相关指标的情况，减轻患者术后疼痛，并能降低患者并发症发生率及术后复发率，临床疗效显著。

Effect of vaginal hysterectomy combined with anterior and posterior vaginal wall repair on postoperative pain and recurrence in patients with uterine prolapse and vaginal prolapse

ObjectiveTo investigate the effect of vaginal hysterectomy combined with anterior and posterior vaginal wall repair on postoperative pain and recurrence in patients with uterus prolapse and vaginal prolapse. MethodsFrom January 2017 to January 2019, ninty cases of uterine prolapse and vaginal prolapse in Ma'anshan central hospital were randomly divided into two groups: control group (n=45 cases) and observation group (n=45 cases). The control group was treated with simple repair of the anterior and posterior walls of the vagina. The observation group was treated with vaginal hysterectomy and repair of anterior and posterior vagina wall. The two groups were followed up for one year. The clinical effect, visual analogue score (VAS) before and after operation were compared between the two groups, and the perioperative operation related indexes, the incidence of complications and the recurrence rate of 1-year follow-up were counted. ResultsThe total effective rate of the observation group was 93.33%, which was significantly higher than 71.11% of the control group (P<0.05). Compared with that before operation, the VAS score of the two groups decreased gradually 3-7 days after operation, and the VAS score of the observation group at 3 day and 7 day was significantly lower than that of the control group (P<0.05). Compared with the control group, the observation group had significantly less intraoperative blood loss, and the difference was statistically significant (P<0.05); the hospital stay, anal exhaust time, and operation time of observation group were significantly shorter, and the differences were statistically significant (P<0.05). The incidence of complications and 1-year follow-up recurrence in the observation group were 6.67% and 2.22%, respectively, which were significantly lower than those in the control group (26.67% and 24.44%, P<0.05). ConclusionVaginal hysterectomy combined with anterior and posterior vagina wall repair can significantly improve the perioperative related indicators, reduce the postoperative pain, and reduce the incidence of complications and postoperative recurrence rate. The clinical effect is significant.