陰式手術治療盆腔臟器脫垂患者的臨床觀察

Clinical observation of the pelvic organ prolapse patients treated with vaginal surgery

盧頴儀(LOU Weng I)

陰式手術 ； 盆腔臟器脫垂 ； 臨床效果 ； Vaginal surgery ； Pelvic organ prolapse ； Clinical effect

鏡湖醫學

21卷1期（2021 / 06 / 01）

50 - 52+65

繁體中文;英文

目的：分析陰式手術治療盆腔臟器脫垂的應用方法與臨床效果。方法：選擇2013年9月～2019年12月本院收治的81例採取陰式手術進行治療的子宮疾病患者作為研究對象。其中單純陰式子宮切除術2例，陰式子宮切除加陰道前壁修補術50例，陰式子宮切除加陰道前後壁修補術29例；術中一併行TVT-O術12例，術中一併行附件手術10例（4例患者為一側附件切除，1例患者為雙側附件切除，3例患者為一側輸卵管切除，2例患者為雙側輸卵管切除）。81例中有腹部手術史者5例。結果：本組81例患者進行手術治療均獲成功，無1例改開腹手術。術中平均出血量為（45.36±43.96）ml，平均手術時間為（83.42±21.95）min，平均拔尿管時間為（4.01±0.81）d，平均住院時間為（7.62±2.33）d。1例膀胱損傷於術中經陰道修復，1例術後陰道流血，再次經陰道手術止血。術後患者平均隨訪時間為（113.28±127.85）天（最短時間30天，最長183天），治癒80例，好轉0例，無效0例，復發1例，治癒率為98.8%，復發率為1.2%。結論：陰式手術具有手術時間短、安全性高、出血量少、手術創傷小、術後疼痛輕、體表不留瘢痕、無腹壁切口、住院時間短、術後患者恢復快等的優點，該療法值得在治療子宮疾病方面推廣應用。

Objective: To evaluate the clinical effects of vaginal surgery for pelvic organ prolapse. Methods: Eighty-one patients with uterine diseases who were treated in our hospital from September 2013 to December2019 were selected and treated with vaginal surgery. There were 2 cases of simple vaginal hysterectomy, 50 cases of vaginal hysterectomy plus anterior vaginal wall repair, 29 cases of vaginal hysterectomy plus anterior and posterior vaginal wall repair, 12 cases of TVT-O surgery, and 10 cases of adnexalsurgery. (Four patients perform a one-sided adnexal resection, one patient perform a bilateral adnexal resection, three patients perform a one-sided fallopian tube resection, and two patients perform a bilateral fallopian tube resection). Among the 81 cases, 5 cases had a history of abdominal surgery. Results: All the 81 patients underwent surgical treatment successfully. None of the patients was transferred to abdominal surgery. The intra-operative blood loss was 45.36±43.96ml, the operation time used was 83.42±21.95 min, the pulling cathetertime was 4.01±0.81 days, the length of hospital stay was 7.62±2.33 days. One case of bladder injury was repaired by vaginal surgery. One case had vaginal bleeding, and the bleeding was stopped by vaginal surgery. The follow-up time of patients was113.28±127.85 days. Among the 81 cases, 80 cases were cured, 0 cases was improved, 0 cases was ineffective, 1 case relapsed. The cure rate were 98.8%, and the recurrence rate was 1.2%. Conclusion: Vaginalsurgery has many advantages including, shorter operation time, higher safety, less bleeding, less surgical trauma, less postoperative pain, no scars on the body surface, no abdominal wall incision, shorter hospital stay, more rapid postoperative recovery, etc. The therapy is worthy of promotion in the treatment of uterine diseases.