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目的分析阴道顶端悬吊术治疗盆腔脏器脱垂(POP)的疗效。方法选取重度POP患者22例,按盆腔脏器脱垂量化(POP-Q)分期Ⅲ期18例,Ⅳ期4例。采用腹腔镜辅助下阴式全子宫切除+阴道顶端骶前悬吊术8例,经腹阴道顶端骶前悬吊术7例,阴道顶端腹直肌前鞘悬吊术7例。回顾性分析其疗效。结果 22例患者术中无脏器损伤、大出血等并发症发生。术后随访3-31个月,解剖学治愈21例,术后6个月出现POP-QⅡ期1例。术后3个月,患者阴道前壁Aa、Ba,后壁Ap、Bp,顶部C点均得到显著纠正。结论阴道顶端悬吊术借助网片可恢复盆底的正常解剖,改善盆底功能,手术安全性较好,术后复发率较低。
Objective To analyze the curative effect of vaginal apical suspension in the treatment of pelvic organ prolapse (POP). Methods Twenty-two patients with severe POP were enrolled. According to POP-Q, 18 cases were stage Ⅲ and 4 cases were stage Ⅳ. Laparoscopic assisted vaginal hysterectomy + vaginal apical presacral suspension in 8 cases, transvaginal vaginal apical presacral suspension in 7 cases, vaginal aponeurosis in 7 cases. Retrospective analysis of its efficacy. Results 22 cases of intraoperative non-organ injury, bleeding and other complications occurred. The patients were followed up for 3-31 months, 21 cases were cured by anatomy and 1 case was POP-QⅡ 6 months after operation. Three months after surgery, the patients had significant correction of Aa, Ba, Ap, Bp and C at the top of the vagina. Conclusion The vaginal apical suspension can recover the normal anatomy of the pelvic floor with the help of mesh, and improve pelvic floor function. The operative safety is good and the postoperative recurrence rate is low.