汤良君 孙艳 张晓红 盛少琴

[摘要]目的：分析改良陰道后壁修补术与点阵二氧化碳激光治疗阴道松弛症的疗效及对女性性功能指数（Female sexual function index，FSFI）评分的影响。方法：2017年7月-2018年5月笔者医院妇科收治的阴道松弛症患者100例，随机分为对照组和观察组，每组50例。观察组采用点阵二氧化碳激光治疗;对照组采用改良阴道后壁修补术治疗。比较两组患者治疗后阴道松紧度，治疗前后客观疗效、FSFI评分和阴道健康指数。结果：治疗后，对照组阴道松紧度显著低于观察组，差异有统计学意义（P<0.05）。治疗后，两组Ⅰ类盆底肌肌力分级与纤维强度，Ⅱ类盆底肌肌力分级与纤维强度均显著高于治疗前，且观察组显著高于对照组，差异有统计学意义（P<0.05）。治疗后，两组阴道润滑度、性生活满意度评分均显著高于治疗前，且观察组均显著高于对照组，差异有统计学意义（P<0.05）。治疗后，两组阴道健康指数评分均显著高于治疗前，且观察组高于对照组，差异有统计学意义（P<0.05）。结论：点阵二氧化碳激光治疗阴道松弛症的疗效比改良阴道后壁修补术更好，FSFI评价更优，能显著改善患者性生活，对患者阴道健康具有促进作用。

[关键词]点阵二氧化碳激光;改良阴道后壁修补术;阴道松弛症;女性性功能指数;阴道健康指数

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）04-0085-04

Clinical Analysis of Fractional CO2 Laser and Modified Vaginal Posterior Wall Repair in the Treatment of Vaginal Laxity

TANG Liang-jun1，SUN Yan1，ZHANG Xiao-hong1，SHENG Shao-qin2

（1.Department of Obstetrics and Gynecology，Xuancheng Central Hospital，Xuancheng 242000，Anhui，China;

2.Department of Obstetrics and Gynecology，Xinhua Hospital，Zhejian University of Traditional Chinese Medicine，Hangzhou 310000，Zhejiang，China）

Abstract： Objective  To analyze the the curative effect and the score of female sexual function index （FSFI） of modified vaginal posterior wall repair and fractional CO2 laser on the treatment of vaginal laxity. Methods  Between July 2017 and May 2018， 100 patients with vaginal laxity admitted to our hospital were divided into the observation group and the control group， with 50 patients in each group. Patients in the observation group were treated with fractional CO2 laser， and patients in the control group were treated with modified vaginal posterior wall repair. The vaginal tightness， objective efficacy， the score of FSFI and vaginal health index were compared between the two group. Results  After treatment， the vaginal tightness of the control group was lower than the observation group， the difference was statistically significant （P<0.05）. After treatment， the muscle strength grade and fiber strength of type Ⅰ pelvic floor muscle and type Ⅱ pelvic floor muscle of the two groups were significantly higher than those before treatment， and the observation group was significantly higher than those of the control group （P<0.05）. After treatment， the score of vaginal lubrication and sexual satisfaction in the observation group and the control group was significantly higher than before treatment （P<0.05）. And the score of vaginal lubrication and sexual satisfaction in the observation group was significantly higher than the control group （P<0.05）. After treatment， the score of vaginal health index of the two groups was significantly higher than before treatment （P<0.05）. And the score of vaginal health index of the observation group was higher than the control group （P<0.05）. Conclusion  The curative effect of fractional CO2 laser in the treatment of vaginal laxity is better than the improved vaginal posterior-wall repair surgery， and the score of FSFI evaluation is better. It can significantly improve the sexual life of patients and promote the vaginal health of patients.

Key words： fractional CO2 laser; modified vaginal posterior wall repair surgery; vaginal relaxation; female sexual function index; vaginal health index

阴道松弛症是女性生育后产生的一种阴道生理结构的变化[1-2]，多由盆腔或阴道壁的支持组织薄弱、阴道壁顺应性降低、阴道感觉神经敏感度下降、阴道口变宽所致[3-5]。阴道松弛往往会引起患者生殖道炎症、尿失禁并发症，同时会对患者与伴侣的感情生活产生不良影响[6]。临床上治疗阴道松弛首选的方法是阴道后壁黏膜切除手术，但其术后容易发生感染，有较多并发症，因此会对患者的日常生活产生较为严重的影响[7]。点阵二氧化碳激光是近年来治疗阴道松弛的一种新技术，临床应用效果良好[8]。关于阴道后壁黏膜切除手术和点阵二氧化碳激光治疗效果的比较目前还没有相关的文献进行报道，因此本研究根据笔者医院改良阴道后壁修补术和点阵二氧化碳激光治疗阴道松弛症的治疗现状，分析其对患者的治疗效果。……