吴晓红　郭红霞

[摘要] 目的 探讨腹腔镜下脱垂子宫腹直肌前鞘悬吊固定术治疗子宫脱垂的临床疗效。 方法 采用回顾性分析方法对我院2016年3月～2017年3月接诊的22例子宫脱垂患者行腹腔镜下腹直肌前鞘悬吊固定术，观察患者治疗后的临床有效率、手术时间、出血量、住院时间等，并对患者进行为期1年的随访，记录复发率。结果 治疗有效率高达95.45%；手术时间为（26.68±3.37）min；术中出血量（18.34±1.43）mL；平均住院时间（5.13±0.67）d；术后未见严重并发症，随访1年，未见复发病例。 结论 腹腔镜下脱垂子宫腹直肌前鞘悬吊固定术是治疗子宫脱垂的有效术式，具有安全、创伤小、近期疗效显著等优点，可在临床推广。

[关键词] 子宫脱垂；腹腔镜手术；腹直肌前鞘悬吊固定术；阴道修补术

[中图分类号] R713.4 [文献标识码] B [文章编号] 1673-9701（2018）20-0079-03

Clinical analysis on 22 cases of uterine prolapse treated with laparoscopic prolapsed uterus anterior rectus sheath suspension and fixation

WU Xiaohong GUO Hongxia

Department of Gynecology and Obstetrics， Shuyang Affiliated， Hospital Nanjing University of Chinese Medicine， Shuyang 223600， China

[Abstract] Objective To observe and investigate the clinical efficacy of laparoscopic prolapsed uterus anterior rectus sheath suspension and fixation in the treatment of uterine prolapse. Methods A retrospective analysis method was used in this study. 22 patients with uterine prolapse who were admitted to our hospital between March 2016 and March 2017 were given laparoscopic anterior rectus sheath suspension and fixation. The clinical efficacy， operation time， amount of blood loss， and hospital stay after treatment were observed. Patients were followed up for 1 year and the recurrence rate was recorded. Results The treatment efficiency was as high as 95.45%；the operation time was（26.68±3.37） min； the amount of intraoperative blood loss was（18.34±1.43）mL； the average length of hospital stay was （5.13±0.67）d； there were no serious complications after surgery. After one year of follow-up，no recurrences were found. Conclusion The laparoscopic prolapsed uterus anterior rectus sheath suspension and fixation is an effective surgical treatment for uterine prolapse. It has such advantages as good safety， less trauma， and significant short-term efficacy， which can be widely promoted in clinical practice.

[Key words] Uterine prolapse； Laparoscopic surgery； Anterior rectus sheath suspension and fixation； Vaginal fixation

子宫脱垂又称子宫脱出，属妇科常见病，指子宫从正常的解剖位置沿阴道下降，宫颈外口达坐骨棘水平以下，甚至子宫完全脱出阴道口以外，患者通常合并阴道前壁/后壁膨出。有关研究指出，子宫脱垂的病因与支持子宫的各个韧带以及骨盆底托力减弱有关，在重体力劳动、营养不良、多产妇女中比较常见[1-2]。以往，临床通常应用曼式手术、阴道封闭术、子宫切除术联合阴道前壁、后壁修补术治疗子宫脱垂，但上述三种手术均存在一定弊端，无法修复患者盆底功能，且对于年老体弱的患者而言，并不能耐受阴道封闭术[3-5]。腹直肌前鞘悬吊固定术是通过将子宫悬吊至腹直肌，帮助子宫恢复正常的生理解剖位置，对于盆底修复改善具有重要意义。……