摘要
目的:探讨经闭孔经阴道无张力尿道中段悬吊带术(TVT-O)治疗女性压力性尿失禁的临床疗效。方法:回顾性分析2008年4月至2012年7月中山大学附属第一医院因压力性尿失禁实施TVT-O术的28例女性患者的临床资料并随访其疗效,通过压力诱发试验及指压试验评价客观疗效,国际尿失禁咨询委员会尿失禁问卷表简表(ICIQ-SF)评价主观疗效。结果:28例患者平均手术时间42.32±22.17分钟,术中出血量27.14±22.83 ml,术后住院天数3.75±1.38天,尿管留置时间2.86±1.27天。术中未发生膀胱、输尿管等损伤,术后未出现尿潴留等近期并发症。28例患者平均随访时间30个月,失访3例(10.7%)。手术治愈率为84.0%(21/25),改善率12.0%(3/25)、无效率4.0%(1/25)、复发率14.3%(3/21)。25例患者手术前后ICIQ-SF漏尿次数、漏尿量、对生活的影响程度评分和ICIQ-SF总分比较,术后均较术前改善,差异均有统计学意义(P<0.001)。远期并发症有排尿不畅5例(20.0%)、尿频尿急3例(12.0%)、大腿疼痛2例(8.0%)等,但均可忍受。结论:TVT-O治愈率较高,并发症发生率低,为治疗压力性尿失禁的可选择方法。
Objective：To evaluate the efficacy of the tension-free vaginal tape obturator（TVT-O）in the treatment of female stress urinary incontinence（SUI）. Methods：The clinical data of 28 patients who had an- ti-incontinence surgery TVT-O between April 2008 and July 2012 were retrospectively analyzed. The efficacy and early failure rate of the TVT-O were evaluated by objective criteria （ cough test） and subjective criteria ICIQ-SF（International Consultation on Incontinence Questionnaire-Short Form）. Results：The mean operat- ing time,intraoperative blood loss,inpatient days after surgery and the catheter retention time of the 28 pa- tients were 42.32 -＋22.17 min,27. 14 ~22.83 ml,3.75 ＋1.38 d and 2.86 ~1.27 d, respectively. There was neither injury of the bladder or ureters during operation nor complications of urinary retention and so on after surgery. The mean follow-up time of was 30 months, three cases lost（10.7% ）. The cure rate was 84.0% （21/25）, improvement rate 12.0% （3/25）, inefficiency rate 4.0% （ 1/25 ）, recurrence rate 14.3% （ 3/21 ）. The times and sum of urinary incontinences, scores of routine life effect and total scores of ICIQ-SF de- creased after surgery significantly（ P 〈 0. 001 ）. Long-term complications were 5 （20.0%） urinary difficulty, 3 （12.0%） urinary urgency,2 （8.0%） groin pain and so on, which were all tolerable. Conclusions： TVT-O is reliable to treat SUI which can reach a high cure rate while has little complications.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2014年第2期120-123,共4页
Journal of Practical Obstetrics and Gynecology
基金
广东省科技计划项目(编号:20120401)
广州市科技计划项目(编号:12A022061820)
