中国实用妇科与产科杂志

中国实用妇科与产科杂志 ›› 2021, Vol. 37 ›› Issue (12): 1202-1205.DOI: 10.19538/j.fk2021120108

• 专题笔谈 • 上一篇    下一篇

高位宫骶韧带悬吊术在盆底重建中的应用

  

  1. 北京大学人民医院妇产科，北京市女性盆底疾病研究重点实验室，北京 100044
  • 出版日期:2021-12-02 发布日期:2021-12-02
  • 通讯作者: 孙秀丽
  • 基金资助:
    国家重点研发计划（2018YFC2002204） 

Application of high uterosacral ligament suspension in pelvic floor reconstruction.

  1. Department of Obstetrics and Gynecology，Peking University People’s Hospital，the Key Laboratory of Female Pelvic Floor Disorders Disease，Beijing 100044，China 
  • Online:2021-12-02 Published:2021-12-02

摘要： 重度盆腔器官脱垂（pelvic organ prolapse，POP）多需手术治疗。POP修复术后复发是困扰临床医生的主要问题。临床研究表明，顶端加固不足是手术后复发的主要高危因素。作为经典的Ⅰ水平悬吊术之一，高位宫骶韧带悬吊术（HUS）可为阴道顶端提供有力支持，并且术后阴道长度及轴向更符合生理解剖。HUS有经腹及经阴道路径。经阴道HUS方便同时行阴道前后壁修补，但因术野暴露困难、有输尿管损伤风险而限制了其在我国的推广应用。保留子宫经阴道腹膜外高位宫骶韧带悬吊术（EHUS）可清晰识别宫骶韧带，输尿管损伤风险低，操作简便，近期疗效好，远期疗效尚待进一步临床研究。

关键词: 盆腔器官脱垂, 修复手术, 高位宫骶韧带悬吊术

Abstract: Surgical treatment is the main therapeutic method for advanced pelvic organ prolapse（POP）. Post-operative recurrence is the major concern for clinicians. Clinical studies have shown that inadequate apical reinforcement is the major risk factor for recurrence. As one of the classic procedures for level Ⅰ suspension，high uterosacral ligament suspension（HUS）has the advantages of providing strong support for the apex，resulting in adequate vaginal length and physiological vaginal axis. HUS can be performed abdominally or vaginally. Trans-vaginal HUS is more convenient than abdominal route in terms of simultaneous vaginal repair，but its clinical application is limited by difficult exposure and risk of ureteral injury. Extraperitoneal high sacral ligament suspension（EHUS）can clearly identify uterosacral ligament and decrease the risk of ureter injury，and it is easy to perform. Its short-term anatomical outcome is good，while the long-term efficacy needs further clinical study.

Key words: pelvic organ prolapse, repair surgery, high uterosacral ligament suspension

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