单孔腹腔镜与阴式骶棘韧带悬吊术治疗盆腔器官脱垂效果分析

目的探讨单孔腹腔镜入路和阴式入路骶棘韧带悬吊术(sacrospinous ligament fixation, SSLF)治疗盆腔器官脱垂(pelvic organ prolapse, POP)的安全性和有效性。 方法回顾性分析2017年1月至2018年12月武汉大学中南医院妇产科收治的47例POP的患者，其中21例行单孔腹腔镜SSLF(单孔腹腔镜组)、26例行阴式SSLF(阴式组)。分析患者的手术时间、术中出血量、住院时间、术后通气时间、临床不良反应发生率(包括术中出血、术后阴道出血、术后排尿困难、漏尿、尿潴留等)、POP－Q(盆腔器官脱垂定量分期法)各指示点测量指标、PFIQ－7(盆底障碍影响简易问卷)、PISQ－12(盆腔脏器脱垂/尿失禁性功能问卷)及患者的复发情况。 结果单孔腹腔镜入路与阴式入路的术中出血量、住院时间、临床不良反应率比较，差异具有统计学意义(P<0.05)；两组的手术时间、术后通气时间比较，差异无统计学意义(P>0.05)；两组的术前和术后POP－Q各指示点测量值、PFIQ－7、PISQ－12都有明显的改善，但两组间差值比较，差异无有统计学意义(P>0.05)；术后随访1年，两组均无复发患者。 结论单孔腹腔镜SSLF对于POP的治疗具有一定的安全性和有效性，可以在临床上推广。

Effect analysis of the treatment for pelvic organ prolapse by laparoendoscopic single-site and transvaginal sacrospinous ligament fixation

ObjectiveDiscuss the type into the road of laparoendoscopic single-site and transvaginal sacrospinous ligament fixation safety and effectiveness for the treatment of pelvic organ prolapse. MethodsRetrospective analysis the 47 patients who treated with pelvic organ prolapse between Jan. 2017 and Dec.2018 in Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University. Among them, 21 patients underwent laparoendoscopic single-site sacrospinous ligament fixation (single hole laparoscopic group), 26 patients underwent transvaginal sacrospinous ligament fixation (vaginal group). Analysis the patients with operation time, intraoperative blood loss, hospital stay, postoperative ventilation time, clinical incidence of adverse reactions (including intraoperative bleeding, postoperative vagina bleeding, postoperative dysuria, urinary leakage, urinary retention, etc), each indicator point measurement of POP-Q, PFIQ-7 grade, PISQ-12 grade and relapse of patients. ResultsThe intraoperative blood loss, hospitalization time, clinical incidence of adverse reactions of laparoendoscopic single-site approach and transvaginal approach had statistically significant differences (P<0.05); two groups of operation time, postoperative ventilation time were no statistically significant difference (P>0.05); two groups of preoperative and postoperative POP-Q each indicator point measurements, PFIQ-7 grade, PISQ-12 score has significant improved, but the above index between two groups of preoperative and postoperative difference is not statistically significant (P>0.05); to postoperative follow-up of one year, two groups of patients had no recurrence. ConclusionsSacrospinous ligament fixation by laparoendoscopic single-site for the treatment of pelvic organ prolapse is safety and effectiveness, which can be popularized in clinic.