发布时间：2022-09-10 13:29:01
二种医治子宫脱垂的手术实际效果较为
今天文章内容：《英国医学杂志》：Online/线上发布
近日，西班牙伊萨勒医院妇产科专家教授Hugo W F van Eijndhoven以及研究人员，科学研究较为了骶棘韧带悬吊术与阴式子宫摘除孑宫骶韧带悬吊术医治子宫脱垂2期及以上临床医学实际效果。 此项科研成果2019年9月10日线上发布于《英国医学期刊》。
子宫脱垂是一种常见的身体问题，因为社会老龄化和肥胖指数升高，患病率不断增加。女性开展垂脱手术终生风险性为11-20％，全球医治子宫脱垂最常见应属阴式子宫切除手术。
2009-2012年，西班牙的四所非教学医院征募了208名身心健康女性，在其中204名身患子宫脱垂2期及之上，要做手术。全部参加者均未盆体手术史，他们随机分组接纳保存子宫的骶棘韧带悬吊术或阴式子宫摘除孑宫骶韧带悬吊术。手术后每一年开展随诊，共随诊五年。综合性取得成功界定为并没有处女膜破了外垂脱，阴道内无突出病症，不网上卖的极品虎王药 用反复手术治疗或反复性垂脱医治。
手术治疗5年之后，骶棘韧带悬吊术组里有1名（1%）女性整形失败，阴道内有令人讨厌的小块物突出且需要再度手术治疗，阴式子宫摘除孑宫骶韧带悬吊术组里有8例（7.8%）女性整形失败并有一样病症，差别为-6.7%。骶棘韧带悬吊术组综合通过率为87%，明显高过阴式子宫摘除孑宫骶韧带悬吊术组（76%）。五年的时长-事件分析表明干预措施并没有差别。
通过5年随诊发觉，骶棘韧带悬吊术与阴式子宫摘除孑宫骶韧带悬吊术对比，明显减少了中骨盆室的解剖学复发性，阴道内无突出，不用再一次手术治疗，提升了手术治疗综合通过率。
附：英文原文
Title: Sacrospinous hysteropexy versus vaginal hysterectomy with uterosacral ligament suspension in women with uterine prolapse stage 2 or higher: observational follow-up of a multicentre randomised trial
Author: Sascha F M Schulten, Renée J Detollenaere, Jelle Stekelenburg, Joanna IntHout, Kirsten B Kluivers, Hugo W F van Eijndhoven
Issue&Volume: 2019/09/10
Abstract:
Objective To evaluate the effectiveness and success of uterus preserving sacrospinous hysteropexy as an alternative to vaginal hysterectomy with uterosacral ligament suspension in 安徽生产的极品虎王是什么药the surgical treatment of uterine prolapse five years after surgery.
Design Observational follow-up of SAVE U (sacrospinous fixation versus vaginal hysterectomy in treatment of uterine prolapse ≥2) randomised controlled trial.
Setting Four non-university teaching hospitals, the Netherlands.
Participants 204 of 208 healthy women in the initial trial (2009-12) with uterine prolapse stage 2 or higher requiring surgery and no history of pelvic floor surgery who had been randomised to sacrospinous hysteropexy or vaginal hysterectomy with uterosacral ligament suspension. The women were followed annually for five years after surgery. This extended trial reports the results at five years.
Main outcome measures Prespecified primary outcome evaluated at five year follow-up was recurrent prolapse of the uterus or vaginal vault (apical compartment) stage 2 or higher evaluated by pelvic organ prolapse quantification 辉腾极品虎王好不好 system in combination with bothersome bulge symptoms or repeat surgery for recurrent apical prolapse. Secondary outcomes were overall anatomical failure (recurrent prolapse stage 2 or higher in apical, anterior, or posterior compartment), composite outcome of success (defined as no prolapse beyond the hymen, no bothersome bulge symptoms, and no repeat surgery or pessary use for recurrent prolapse), functional outcome, quality of life, repeat surgery, and sexual functioning.
Results At five years, surgical failure of the apical compartment with bothersome bulge symptoms or repeat surgery occurred in one woman (1%) after sacrospinous hysteropexy compared with eight women (7.8%) after vaginal hysterectomy with uterosacral ligament suspension (difference?6.7%, 95% confidence interval ?12.8% to?0.7%). A statistically significant difference was found in composite outcome of success between sacrospinous hysteropexy and vaginal hysterectomy (89/102 (87%) v 77/102 (76%). The other secondary outcomes did not differ. Time-to-event analysis at five years showed no differences between the interventions.
Conclusions At five year follow-up significantly less anatomical recurrences of the apical compartment with bothersome bulge symptoms or repeat surgery were found after 极品虎王厂家 sacrospinous hysteropexy compared with vaginal hysterectomy with uterosacral ligament suspension. After hysteropexy a higher proportion of women had a composite outcome of success. Time-to-event analysis showed no differences in outcomes between the procedures.
DOI: 10.1136/bmj.l5149
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BMJ-British Medical Journal:《英国医学杂志》，发刊于1840年。归属于BMJ出版集团，全新IF：27.604
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