腹腔镜下Cooper韧带悬吊术与其他手术方式治疗子宫脱垂疗效比较的临床研究
Clinical Study on the Comparison of Efficacyof Laparoscopic Cooper Ligament Suspension with Other Surgical Methods in the Treatment of Uterine Prolapse
摘要: 目的：探讨腹腔镜下Cooper带悬吊术治疗子宫脱垂的临床疗效。方法：选取2009年1月至2022年3月于临沂市中心医院因盆腔器官脱垂行手术治疗的患者365例，共分为四组，(A组)传统经阴道子宫切除 + 阴道壁修补术73例，(B组)经阴推进式子宫切除 + 阴道残端钢性重建 + 网片前盆重建术或者 + 会阴体重建术82例，(C组)腹腔镜下全子宫切除 + 阴道残端骶骨韧带悬吊术89例，(D组)腹腔镜(宫颈/阴道残端/宫颈残端) Cooper韧带悬吊术121例。比较四组患者手术时间、术中出血量、术后住院时间以及随访病人的盆底功能障碍的治疗效果情况。结果：C、D组手术时间略长，而D组手术时间比C组短，两组出血量均较少，复发患者少，A、B两组手术时间短出血量少，复发患者较C、D两组略多，住院天数无明显差异。结论：腹腔镜(宫颈/阴道残端/宫颈残端) Cooper韧带悬吊术是治疗子宫脱垂的简便、安全、有效的手术方式。
Abstract: Objective: To evaluate the clinical effect of laparoscopic Cooper ligament suspension in the treat-ment of uterine prolapse. Methods: A total of 365 patients undergoing surgical treatment for pelvic organ prolapse in Linyi Central Hospital from January 2009 to March 2022 were selected. They were divided into A, B, C and D groups. Group A: 73 patients were treated with traditional transvaginal hysterectomy and vaginal wall repair. Group B: 82 patients were treated with transvaginal hyster-ectomy, vaginal stump reconstruction and anterior pelvic reconstruction with mesh and recon-struction of perinea. Group C: 89 patients were treated with laparoscopic hysterectomy and sacral ligament suspension. Group D: 121 patients were treated with laparoscopic (cervical/vaginal stump/cervical stump) Cooper ligament suspension. The operative time, intraoperative bleeding, hospitalization days and efficacy were compared among the four groups. Results: The operation time of group C and D were slightly longer, while the group D was shorter than that of group C, with less bleeding and recurrence in both groups. The operation time of group A and B was shorter with less bleeding, but more patients with recurrence than that of group C and D, and there was no sig-nificant difference in the length of hospitalization days. Conclusion: Laparoscopic (Cervical/vaginal stump/cervical stump) cooper ligament suspension with laparoscopy is a simple, safe and effective method for the treatment of uterine prolapse.
文章引用：曹佃霞, 林立波, 付晶晶, 娄琰琰, 郝长宏. 腹腔镜下Cooper韧带悬吊术与其他手术方式治疗子宫脱垂疗效比较的临床研究[J]. 临床医学进展, 2023, 13(9): 13941-13947. https://doi.org/10.12677/ACM.2023.1391949

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