女性盆底器官脱垂腹腔镜手术治疗进展
Advances in the Treatment of Laparoscopic Surgery for Female Pelvic Organ Prolapse
DOI: 10.12677/acm.2025.1551546, PDF,    科研立项经费支持
作者: 骆 冰, 林伟钊*, 朱耀魁*:暨南大学附属第一医院妇产科,广东 广州
关键词: 盆底器官脱垂腹腔镜手术治疗进展综述Pelvic Organ Prolapse Laparoscopic Surgery Treatment Progress Review
摘要: 长久以来,女性盆底器官脱垂(POP)作为一种危害女性身心健康及日常生活质量的医疗问题,始终占据着医学研究领域的重要位置。鉴于POP病情程度的多样性,其治疗方案同样展现出丰富的个性化特征。针对中到重度POP病例,当前医学界普遍倾向于将腹腔镜手术视为首选治疗手段。本文旨在梳理并综述临床实践中采用的多种腹腔镜手术方式,旨在为临床决策与治疗路径提供有价值的参考依据。
Abstract: For a long time, pelvic organ prolapse (POP) in women has consistently occupied a significant position in medical research as a medical issue that profoundly impacts women’s physical and mental health, as well as their daily quality of life. Given the variability in the severity of POP, its treatment regimens also exhibit a wealth of personalized characteristics. For moderate to severe cases of POP, the medical community currently tends to regard laparoscopic surgery as the preferred therapeutic approach. This article aims to sort out and review the various laparoscopic surgical methods employed in clinical practice, providing valuable references for clinical decision-making and treatment pathways.
文章引用:骆冰, 林伟钊, 朱耀魁. 女性盆底器官脱垂腹腔镜手术治疗进展[J]. 临床医学进展, 2025, 15(5): 1703-1709. https://doi.org/10.12677/acm.2025.1551546

参考文献

[1] Iglesia, C.B. and Smithling, K.R. (2017) Pelvic Organ Prolapse. American Family Physician, 96, 179-185.
[2] Vergeldt, T.F.M., Weemhoff, M., IntHout, J. and Kluivers, K.B. (2015) Risk Factors for Pelvic Organ Prolapse and Its Recurrence: A Systematic Review. International Urogynecology Journal, 26, 1559-1573. [Google Scholar] [CrossRef] [PubMed]
[3] Rahkola-Soisalo, P., Savolainen-Peltonen, H., Gissler, M., Hoti, F., Vattulainen, P., Ylikorkala, O., et al. (2019) Postmenopausal Hormone Therapy Is Accompanied by Elevated Risk for Uterine Prolapse. Menopause, 26, 140-144. [Google Scholar] [CrossRef] [PubMed]
[4] Richter, K. (1982) Massive Eversion of the Vagina: Pathogenesis, Diagnosis, and Therapy of the “True” Prolapse of the Vaginal Stump. Clinical Obstetrics and Gynecology, 25, 897-912. [Google Scholar] [CrossRef] [PubMed]
[5] Amani, F.Z., Denas, A., Paraton, H., Hardianto, G., Mardiyan K, E. and Hartono S, T. (2021) Comparison of Laparoscopic and Abdominal Sacrocolpopexy for Post Hysterectomy Vaginal Vault Prolapse Repair: Meta Analysis. Medical and Health Science Journal, 5, 33-44. [Google Scholar] [CrossRef
[6] Shahid, U., Chen, Z. and Maher, C. (2024) Sacrocolpopexy: The Way I Do It. International Urogynecology Journal, 35, 2107-2123.
[7] 汤雅贞, 许晓贞, 庄月珍, 等. 腹腔镜下阴道骶骨固定术治疗子宫脱垂的临床价值[J]. 实用中西医结合临床, 2023, 23(9): 32-35.
[8] 赵慧芳, 郭建宾, 叶扬, 等. 骶骨固定术治疗盆腔脏器脱垂术后并发症研究进展[J]. 中国计划生育和妇产科, 2024, 16(9): 51-54.
[9] 朱洁云, 张丽明, 俞利明. 子宫韧带阴道残端悬吊术预防腹腔镜下非脱垂子宫全切除术后阴道脱垂的临床研究[J]. 中国现代药物应用, 2022, 16(13): 62-65.
[10] Barber, M.D., Visco, A.G., Weidner, A.C., Amundsen, C.L. and Bump, R.C. (2000) Bilateral Uterosacral Ligament Vaginal Vault Suspension with Site-Specific Endopelvic Fascia Defect Repair for Treatment of Pelvic Organ Prolapse. American Journal of Obstetrics and Gynecology, 183, 1402-1411. [Google Scholar] [CrossRef] [PubMed]
[11] Shull, B.L., Bachofen, C., Coates, K.W. and Kuehl, T.J. (2000) A Transvaginal Approach to Repair of Apical and Other Associated Sites of Pelvic Organ Prolapse with Uterosacral Ligaments. American Journal of Obstetrics and Gynecology, 183, 1365-1374. [Google Scholar] [CrossRef] [PubMed]
[12] Cai, L., Qu, X., Xu, L., Cao, J. and Li, D. (2023) High Uterosacral Ligament Suspension in Radical Hysterectomy: A Step-By-Step Procedure to Prevent Pelvic Organ Prolapse. International Urogynecology Journal, 34, 2839-2842. [Google Scholar] [CrossRef] [PubMed]
[13] 罗春佳. 腹腔镜下子宫骶韧带高位悬吊术对子宫脱垂治疗价值观察[J]. 实用妇科内分泌电子杂志, 2019, 6(26): 157.
[14] Leron, E., Erez, O., Shwarzmam, P. and Baessler, K. (2022) Sacrospinous Ligament Fixation (SSLF): An Old Method with New Horizons. Archives of Gynecology and Obstetrics, 305, 1379-1382. [Google Scholar] [CrossRef] [PubMed]
[15] 彭子萍, 罗婷, 季强. 保留子宫的腹腔镜后路骶棘韧带悬吊术治疗中重度中盆腔缺陷的疗效观察[J]. 临床和实验医学杂志, 2022, 21(21): 2315-2319.
[16] 李娟, 修晨, 牛翠丽, 等. 圆韧带联合骶韧带悬吊预防子宫切除术后盆底功能障碍的效果[J]. 蚌埠医学院学报, 2023, 48(3): 349-353.
[17] 黄莉莉. 腹腔镜筋膜内全子宫切除圆韧带阴道残端悬吊的临床研究[J]. 现代诊断与治疗, 2024, 35(3): 442-444.
[18] Banerjee, C. and Noé, K.G. (2010) Laparoscopic Pectopexy: A New Technique of Prolapse Surgery for Obese Patients. Archives of Gynecology and Obstetrics, 284, 631-635. [Google Scholar] [CrossRef] [PubMed]
[19] Khoiwal, K., Dash, K.C., Gaurav, A. and Chaturvedi, J. (2023) Comparison of Laparoscopic Pectopexy with the Standard Laparoscopic Sacropexy for Apical Prolapse: An Exploratory Randomized Controlled Trial. Journal of the Turkish-German Gynecological Association, 24, 144-151. [Google Scholar] [CrossRef] [PubMed]
[20] 芦珍珍, 王璐, 栗浩然, 等. 腹腔镜下全子宫切除加髂耻韧带悬吊术治疗中盆腔器官脱垂的疗效分析[J]. 现代妇产科进展, 2020, 29(7): 522-526, 530.
[21] 林瑞莲, 彭燚琼, 解斐, 等. 腹腔镜髂耻韧带悬吊术、骶韧带悬吊术治疗盆腔器官脱垂的对照研究[J]. 中外医疗, 2024, 43(9): 1-4, 10.
[22] 张朋辉. 腹腔镜宫颈腹壁悬吊术与全子宫切除阴道残端腹壁悬吊术治疗盆腔器官脱垂的临床分析[D]: [硕士学位论文]. 杭州: 浙江中医药大学, 2024.
[23] 黄兰婕, 陈威, 朱耀魁. 腹腔镜下子宫腹直肌前鞘悬吊固定术治疗盆腔脏器脱垂的临床疗效[J]. 中华妇幼临床医学杂志(电子版), 2018, 14(2): 241-248.
[24] 王斐斐. 腹腔镜腹直肌前鞘悬吊在子宫脱垂患者中的应用效果[J]. 西藏医药, 2022, 43(4): 68-70.
[25] 沈莉平. 盆底重建手术围手术期的护理体会[J]. 青海医药杂志, 2018, 48(4): 21-22.
[26] 段吉霏, 于瑞雪, 陈素钦. 快速康复外科理念在妇科盆底重建手术围术期中的应用效果[J]. 中国计划生育学杂志, 2023, 31(9): 2105-2109.
[27] 姚金香, 武智甜, 姜娟. 盆底训练联合电刺激生物反馈疗法对老年子宫脱垂术后患者的影响[J]. 齐鲁护理杂志, 2024, 30(4): 155-157.