吴明秀 李秋萍 张斌

【摘要】 目的：对比三種手术方式治疗盆腔器官脱垂的效果。方法：选取2018年1-12月笔者所在医院收治的需手术治疗的盆腔器官脱垂患者80例，按其选择的手术方式不同分成A、B、C三组，A组采用腹腔镜下非网片植入的盆底自身组织重建术进行治疗，B组采用腹腔镜下网片植入的阴道骶骨固定术进行治疗，C组采用传统全子宫切除、阴道前后壁修补、会阴体修补术进行治疗，对比三组治疗效果、手术时间、术中出血量、副损伤、住院时间、住院费用、耗材占比及复发率。结果：A组与B组治疗总有效率比较差异无统计学意义（P>0.05），C组治疗总有效率均低于A组与B组，差异均有统计学意义（P<0.05）;三组手术时间、住院时间比较差异无统计学意义（P>0.05），B组术中出血量少于A组，但差异无统计学意义（P>0.05），C组术中出血量均高于A组、B组，差异均有统计学意义（P<0.05）;三组副损伤发生率均为0，差异无统计学意义（P>0.05），A组与B组复发率均为3.70%（1/27），差异无统计学意义（P>0.05），C组复发率为30.76%（8/26），均高于A组与B组，差异均有统计学意义（P<0.05）;A组与C组住院费用、耗材占比比较差异无统计学意义（P>0.05），B组住院费用、耗材占比均高于A组与C组，差异均有统计学意义（P<0.05）。结论：采用腹腔镜下非网片植入的盆底自身组织重建术治疗盆腔器官脱垂，不仅有着确切的疗效，同时治疗费用较低，可以考虑积极推广。

【关键词】 手术方式 盆腔器官脱垂 疗效对比

doi：10.14033/j.cnki.cfmr.2020.17.013 文献标识码 B 文章编号 1674-6805（2020）17-00-03

The Comparison of Three Surgical Methods in Treatment of Pelvic Organ Prolapse/WU Mingxiu， LI Qiuping， ZHANG Bin. //Chinese and Foreign Medical Research， 2020， 18（17）： -35

[Abstract] Objective： To compare the effects of three surgical methods on pelvic organ prolapse. Method： From January to December 2018， 80 patients with pelvic organ prolapse who needed surgical treatment were selected as the object of this study. They were divided into group A （n=27）， group B （n=27）， and group C （n=26） according to the surgical method they chose. Patients in group A were treated with laparoscopic non-mesh implanted pelvic floor autologous tissue reconstruction， patients in group B were treated with laparoscopic mesh implantation of vaginal patella fixation， patients in group C were treated with traditional total hysterectomy， anterior and posterior vaginal wall repair， and perineal body repair. The treatment effects and surgery time， intraoperative blood loss， side injuries， length of hospital stay， hospitalization cost， proportion of consumables， and recurrence rate of the three groups were compared. Result： There was no significant difference in the total effective rate between group A and group B （P>0.05）， the total effective rate of treatment in group C was lower than those in group A and group B， the differences were statistically significant （P<0.05）. There was no significant difference in operation time and hospital stay between the three groups （P>0.05）， the intraoperative blood loss in group B was less than that in group A， but the difference was not statistically significant （P>0.05）， the intraoperative blood loss in group C was higher than that in group A and group B， the differences were statistically significant （P<0.05）. The incidence of side injuries in all three groups was 0， and the difference was not statistically significant （P>0.05）， the recurrence rate of both group A and group B was 3.70% （1/27）， and the difference was not statistically significant （P>0.05）， the recurrence rate of group C was 30.76% （8/26）， which was higher than that in group A and group B， the differences were statistically significant （P<0.05）. There was no statistically significant difference in the proportion of hospitalization expenses and consumables between group A and group C （P>0.05）， the proportion of hospitalization expenses and consumables in group B was higher than that in group A and group C， and the differences were statistically significant （P<0.05）. Conclusion： The treatment of pelvic organ prolapse by laparoscopic non-mesh implantation of pelvic floor self-tissue reconstruction is not only effective， but also less expensive， so it can be actively promoted.

[Key words] Surgical method Pelvic organ prolapse Efficacy comparison

First-authors address： Xiegang Hospital District of Dongguan Peoples Hospital， Dongguan 523600， China

在妇科疾病中，盆腔器官脱垂属于常见病，对患者身心健康有着一定影响[1]。本文就三种手术方式治疗盆腔器官脱垂的临床疗效做出相关的研究，其报道见下。

1 资料与方法

1.1 一般资料

选取2018年1-12月笔者所在医院收治的盆腔器官脱垂患者80例。纳入标准：患者病情按POP-Q诊断标准分为Ⅲ或Ⅳ度;有手术意愿。排除标准：精神疾病或认知障碍，无法正常交流;手术禁忌证。根据自愿原则选择手术方式，将其分为A组（n=27）、B组（n=27）、C组（n=26），三组一般资料比较差异无统计学意义（P>0.05），具有可比性，见表1。患者均对此次研……