标题：腹腔镜下不同手术方式治疗年轻子宫脱垂患者的有效性和安全性研究

      作者：张青冬，汪萍萍    (鄂东医疗集团黄石市中心医院湖北理工学院附属医院妇产科，湖北 黄石 435000)

      卷次： 2016年27卷22期

      【摘要】 目的 探讨腹腔镜下高位宫骶韧带悬吊术(HUS)与经阴道骶棘韧带固定术(SSLF)两种术式治疗年轻子宫脱垂患者的临床效果及安全性。方法 选取黄石市中心医院2013年4月至2014年12月诊治的119例年轻子宫脱垂患者进行回顾性研究，根据手术方式分为HUS组57例和SSLF组62例，HUS组采用高位宫骶韧带悬吊术，SSLF组采用经阴道骶棘韧带固定手术治疗，比较两组患者的手术治疗效果。结果 两组患者的手术时间、术中出血量、术后病率、解剖治愈率、自主排尿恢复时间、住院时间组间比较差异均无统计学意义(P>0.05)；HUS组患者的大腿及臀部疼痛率(3.51%)、新发尿失禁率(3.51%)、性交疼痛率(1.75%)、复发率(1.75%)与SSLF组(6.45%、6.45%、8.06%、4.84%)比较差异均无统计学意义(P>0.05)。术后两组患者的Aa、Ba、C、Ap、Bp测量值均较术前明显降低，差异均有统计学意义(P<0.05)；术后，HUS组患者的PFDI-20评分、PFIQ评分分别为(7.6±2.3)分、(8.5±2.4)分，SSLF组PFDI-20评分、PFIQ评分分别为(8.0±2.5)分和(8.8±2.7)分，两组患者术后的PFDI-20评分、PFIQ评分较术前均显著的降低，差异均有统计学意义(P<0.05)。结论 高位宫骶韧带悬吊术与经阴道骶棘韧带固定手术治疗年轻子宫脱垂患者均能够取得较好的临床效果，有利于患者术后生活质量的改善。
      【关键词】 腹腔镜；位宫骶韧带悬吊术；经阴道骶棘韧带固定术；子宫脱垂；临床效果；安全性
      【中图分类号】 R711.74 【文献标识码】 A 【文章编号】 1003—6350（2016）22—3675—04

Efficacy and safety of two laparoscopic surgical methods in the treatment of young patients with uterine prolapse.ZHANG Qing-dong, WANG Ping-ping.
Department of Obstetrics and Gynecology, Huangshi Central Hospital, East HubeiProvincial Medical Group/the Affiliated Hospital of Hubei Polytechnic University, Huangshi 435000, Hubei, CHINA
【Abstract】 Objective To investigate the clinical effect and safety of laparoscopic high uterosacral ligamentsuspension (HUS) and sacrospinous ligament fixation (SSLF) in the treatment of young patients with uterine prolapse.Methods One hundred and nineteen young patients with uterine prolapse in Huangshi Central Hospital from April2013 to December 2014 were selected and divided into two groups according to the operation method: 57 cases of HUSgroup (treated with HUS) and 62 cases of SSLF group (treated with SSLF). The surgical treatment effects were com-pared between the two groups. Results There were no significant differences in operation time, blood loss, postopera-tive morbidity, anatomical cure rate, recovery time of automatic micturition and length of hospital stay between the twogroups (P>0.05). The thigh and hip pain rate (3.51%), new-onset urinary incontinence rate (3.51%), pain during inter-course rate (1.75%), relapse rate (1.75%) in HUS group were significantly higher those in SSLF group (6.45%, 6.45%,8.06%, 4.84%), with statistically significant differences (P>0.05). After surgery, the values of Aa, Ba, C, Ap, Bp in thetwo groups were significantly lower than those before surgery, and the differences were statistically significant (P<0.05).After surgery, the postoperative PFDI-20 score and PFIQ score were (7.6 ± 2.3) points and (8.5 ± 2.4) points in HUSgroup, (8.0±2.5) points and (8.8±2.7) points in SSLF group, which were significantly lower than those before operation(P<0.05). Conclusion HUS and SSLF in the treatment of young patients with uterine prolapse are able to achieve goodclinical results, which is conducive to the improvement of the quality of life of patients after surgery.
      【Key words】 Laparoscopy; High uterosacral ligament suspension (HUS); Sacrospinous ligament fixation(SSLF); Uterine prolapse; Clinical efficacy; Safety·论 著·doi:10.3969/j.issn.1003-6350.2016.22.022基金项目：湖北省自然科学基金（编号：2015CFB701）