林莉香 云红叶

[摘要]目的：探討阴道旁修补术联合提肛锻炼治疗重度阴道松弛症的临床效果。方法：将2018年10月-2020年10月中南大学湘雅医学院附属海口医院妇产科收治的重度阴道松弛患者80例随机分为常规组和锻炼组，每组40例。常规组采用腹腔镜下改良的阴道旁修补术治疗，锻炼组在常规组基础上结合提肛锻炼。比较两组临床疗效、阴道松弛情况、性生活质量、盆底肌力和排尿控制满意度。结果：与常规组相比，锻炼组总有效率和排尿控制满意度明显较高，差异有统计学意义（P<0.05）。与治疗前相比，治疗后两组阴道松弛问卷评分、性生活质量问卷评分、性功能量表评分和盆底肌力指标（Ⅰ类纤维强度、Ⅱ类纤维强度、Ⅰ类纤维收缩时间、Ⅱ类纤维收缩数量）均明显升高，且锻炼组明显高于常规组，差异有统计学意义（P<0.05）。结论：阴道旁修补术联合提肛锻炼治疗重度阴道松弛症效果显著，可改善患者的阴道松弛状况，提高性生活质量、盆底肌功能和对排尿控制的满意度。

[关键词]阴道松弛症;重度;阴道旁修补术;提肛锻炼;性生活质量;盆底肌力

[中图分类号]R713.3    [文献标志码]A    [文章编号]1008-6455（2022）06-0055-04

Clinical Efficacy of Paravaginal Repair Combined with Anal Lifting Exercise in the Treatment of Severe Vaginal Laxity

LIN Lixiang，YUN Hongye

（Department of Obstetrics and Gynecology，Haikou Affiliated Hospital of Central South University Xiangya School of Medicine，Haikou 570208，Hainan，China）

Abstract： Objective  To explore the clinical effect of paravaginal repair combined with anal lifting exercise in the treatment of severe vaginal relaxation. Methods  80 patients with severe vaginal laxity collected in our hospital from October 2018 to October 2020 were randomly divided into the routine group and the exercise group， 40 cases in each group. The routine group was treated with modified vaginal repair under laparoscope， and the exercise group was combined with anal lifting exercise on the basis of the routine group. The clinical efficacy， vaginal relaxation， sexual life quality， pelvic floor muscle strength and micturition control satisfaction of the two groups were compared. Results  Compared with the routine group， the total effective rate and satisfaction of micturition control in the exercise group were significantly higher， the differences were statistically significant （P<0.05）. Compared with before treatment， the vaginal relaxation questionnaire score， sexual life quality questionnaire score， sexual function scale score and pelvic floor muscle strength index of type Ⅰ fiber strength， type Ⅱ fiber strength， type Ⅰ fiber contraction time and type Ⅱ fiber contraction quantity of the two groups were significantly increased after treatment， and the exercise group was significantly higher than the routine group （P<0.05）. Conclusion  The effect of paravaginal repair combined with anal lifting exercise in the treatment of severe vaginal relaxation is significant， which can improve the vaginal relaxation status of patients， improve the quality of sexual life， pelvic floor muscle function and satisfaction with micturition control.

Key words： vaginal laxity; severe; paravaginal repair; anal lifting exercise; quality of sexual life; pelvic floor muscle strength

阴道松弛症是因盆底肌及阴道周围结缔组织改变而引起的阴道壁和（或）阴道口松弛的一种妇科常见病，其发生与阴道分娩和年龄增长等密切相关，给女性的性生活质量带来很大影响[1]。手术是治疗阴道松弛症的常用方法，传统的阴道前壁修补术因有不能纠正阴道旁缺陷、复发率高和远期疗效差等不足，已逐渐被阴道旁修补术取代[2-3]。……