目的 探讨三种基于自体组织的阴道前壁修复术式在前盆腔器官脱垂（POP）患者中的临床疗效及安全性，为前盆腔脱垂手术方式的选择提供参考。方法 回顾性分析2017年1月至2023年6月佛山市妇幼保健院收治的88例POP并接受手术治疗患者的临床资料。所有患者中、后盆腔均采用统一术式，即经阴道全子宫切除术联合阴道残端右侧骶棘韧带固定、阴道后壁修补及会阴陈旧性裂伤修补术。根据前盆腔修复方式不同分为3组：A组（子宫骶韧带-耻骨阴道肌交叉固定术，26例）、B组（传统阴道前壁修补术，31例）和C组（阴道前壁筋膜瓣耻骨骨膜悬吊术，31例）。比较3组患者术前一般资料、围手术期情况、术前及术后3个月POP定量分度法（POP-Q）指示点变化，并采用盆底功能障碍问卷（PFDI-20）评估生活质量，同时分析术后并发症发生情况。结果 3组患者术前一般资料及中、后盆腔脱垂指示点比较差异均无统计学意义（P>0.05）。术前3组前盆腔脱垂指示点Aa、Ba比较差异有统计学意义（P<0.05），A组和C组脱垂程度重于B组。术后3个月随访显示，3组患者POP-Q各指示点及PFDI-20评分均较术前明显改善（P<0.05），术后各组脱垂指示点比较差异无统计学意义（P>0.05）。A组术后PFDI-20评分高于B组（P<0.05）。3组术后远期并发症发生率比较差异无统计学意义（P>0.05）。结论 三种自体组织前盆腔修复术式均可有效改善POP患者的解剖结构及生活质量。子宫骶韧带-耻骨阴道肌交叉固定术更适用于前盆腔脱垂程度较重的患者，临床应用中应合理选择术式。

Objective To explore the clinical efficacy and safety of three autologous tissue-based anterior vaginal wall repair for patients with anterior pelvic organ prolapse （POP），and to provide reference for the selection of surgical approaches. Methods A retrospective analysis was conducted on the clinical data of 88 patients with anterior POP who underwent surgical treatment at Foshan Maternal and Child Health Hospital from January 2017 to June 2023. All patients received the same surgical procedures for the middle and posterior compartments，including vaginal hysterectomy combined with right sacrospinous ligament fixation of the vaginal vault，posterior vaginal wall repair，and repair of old perineal lacerations. According to the anterior compartment repair technique，patients were divided into three groups： Group A （sacro-ligament-pubovaginal muscle cross-fixation，n=26），Group B （traditional anterior vaginal wall repair，n=31），and Group C （anterior vaginal fascial flap suspension to the pubic periosteum，n=31）. Baseline data，perioperative outcomes，changes in pelvic organ prolapse quantification （POP-Q） points before surgery and at 3 months postoperatively were compared and Pelvic Floor Distress Inventory-20 （PFDI-20） was used to evaluate life quality; meanwhile, postoperative complications were compared. Results There were no significant differences in baseline data or middle and posterior compartment POP-Q points among the three groups before surgery （P>0.05）. Significant differences were observed in preoperative anterior compartment points Aa and Ba （P<0.05），with more severe prolapse in Groups A and C than in Group B. At 3 months postoperatively，all POP-Q points and PFDI-20 scores in the three groups showed significant improvement compared with those before operation （P<0.05），while no significant differences were found in postoperative POP-Q points among the groups （P>0.05）. The postoperative PFDI-20 score in Group A was higher than that in Group B（P<0.05）. There were no significant differences in the incidence of long-term postoperative complications among the three groups （P>0.05）. Conclusions All three autologous tissue-based anterior vaginal wall repair procedures can effectively improve anatomical outcomes and quality of life in patients with anterior POP. Sacro-ligament-pubovaginal muscle cross-fixation is more suitable for patients with more severe anterior compartment prolapse; however，it is associated with relatively higher postoperative subjective pelvic floor distress，and appropriate selection of surgical procedure is required in clinical practice.