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目的:比较经腹阴道骶前固定术与经腹腔镜阴道骶骨固定术治疗阴道穹窿脱垂围手术期情况和术后并发症、为提高手术的安全性和疗效提供依据。方法:选择对象为2010年2月~2012年6月由新疆维吾尔自治区人民医院妇科收治的,经POP-Q分度为III/IV度的阴式全子宫切除术后阴道穹窿脱垂行手术治疗的中老年女性患者24例,行经腹阴道骶前固定术13例(ASCP组),经腹腔镜阴道骶前固定术11例(LSCP组)。术后6周、6个月及1年对两组患者随访。从而评价两组患者的围手术期情况及术后并发症发生情况。结果:两组患者均顺利完成手术,LSCP组术出血量少于ASCP组,平均住院天数比ASCP组短,两组比较有统计学意义,平均手术时间无统计学意义,两组术中并发症及术后晚期并发症发生情况差异无统计学意义(>0.05)。两组术后早期并发症差异有统计学意义(<0.05)。结论:LSCP组术中出血少,术后住院时间短,术后发生切口感染,尿路感染,肠梗阻等并发症较ASCP组少见,手术时间,术中并发症及术后早期并发症发生率相当,腹腔镜下骶骨阴道固定术治疗阴道穹窿脱垂创伤小,恢复快,并发症少,是一种安全有效的治疗方法。
Objective: To compare the operative conditions and postoperative complications of transvaginal sacral fixation and laparoscopic vaginal sacral fixation in the treatment of vaginal vault prolapse, so as to provide evidence for improving the safety and efficacy of surgery. Methods: The subjects were selected from gynecology department of People’s Hospital of Xinjiang Uygur Autonomous Region from February 2010 to June 2012. Surgical treatment of vaginal vault prolapse after vaginal hysterectomy with POP-Q index III / IV was performed 24 cases of middle-aged and elderly women, 13 cases underwent transvaginal presacral fixation (ASCP group) and 11 cases underwent laparoscopic vaginal presacral fixation (LSCP group). The patients were followed up for 6 weeks, 6 months and 1 year after operation. To evaluate the two groups of perioperative patients and postoperative complications. Results: The operation of both groups was successfully completed. The LSCP group had less blood loss than the ASCP group and the average length of hospital stay was shorter than that of the ASCP group. The two groups were statistically significant and the average operation time was not statistically significant. Two groups of intraoperative complications There was no significant difference in the incidence of postoperative complications (> 0.05). There were significant differences in the early postoperative complications between the two groups (<0.05). Conclusions: LSCP group had less intraoperative bleeding, shorter postoperative hospital stay, postoperative incision infection, urinary tract infection, intestinal obstruction and other complications than ASCP group. The operation time, intraoperative complications and early postoperative complications Equivalent, laparoscopic sacral vaginoplasty treatment of vaginal vault prolapse small trauma, rapid recovery, fewer complications, is a safe and effective treatment.