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目的:探讨经阴道后路悬吊带术(PIVS)治疗女性阴道穹隆膨出的中远期结局。方法:采用回顾性研究方法,对20名子宫切除术后阴道穹隆膨出的患者行PIVS治疗。对其术前、术后资料进行评估,并对术后3年以上随访结果进行总结。结果:平均手术时间53.95±16.88min,术中平均出血量57.50±24.682ml,平均住院天数3.82天,未发生直肠损伤、盆腔血肿等术中严重并发症。半年内所有患者均治愈,中远期随访2例(10.5%)患者因阴道穹隆脱垂复发行子宫托治疗;5例(26.3%)出现吊带侵蚀,剪除后加用雌激素局部治疗,4例好转,1例反复修剪侵蚀的吊带3次,仍有肉芽形成。结论:PIVS术是一种安全、有效、微创的治疗阴道穹隆膨出的手术方式,但术后中远期随访发现吊带侵蚀是一个不可忽视的问题,该术式所用多股编织吊带不宜作为重建材料。
Objective: To investigate the long-term outcome of transvaginal posterior vaginal dilation (PIVS) in the treatment of female vaginal vault bulging. Methods: A retrospective study was performed on 20 patients with vaginal vault bulging after hysterectomy undergoing PIVS. Preoperative and postoperative data were evaluated, and the follow-up results of more than 3 years after surgery were summarized. Results: The average operation time was 53.95 ± 16.88min, the average amount of intraoperative bleeding was 57.50 ± 24.682ml, the average length of hospital stay was 3.82 days. There were no serious complications such as rectal injury and pelvic hematoma. All the patients were cured in half a year. Two cases (10.5%) were followed up for vaginal fornix prolapse with pessary in 5 cases (26.3%). Surgical treatment with estrogen after excision was performed in 5 cases (26.3% Improvement, 1 case of repeated trimming erosion sling 3 times, there are still granulation formation. Conclusion: PIVS is a safe, effective and minimally invasive surgical method for the treatment of vaginal vault bulging. However, it is not negligible to follow the long-term follow-up of the vaginal vault. The multi-strand braided sling used in this procedure should not be used as Reconstruction of materials.