老年女性压力性尿失禁手术治疗疗效分析  

Analysis on the treatment of elderly woman stress urinary incontinence with operation

作　　者：樊伯珍[1] 夏红[1] 陈信良[1] 赵勇锋[1] 李怀芳[1] 童晓文[1] 

机构地区：[1]上海同济大学附属同济医院妇产科,200065

出　　处：《中华老年医学杂志》2005年第5期351-354,共4页Chinese Journal of Geriatrics

摘　　要：目的评价手术治疗老年女性压力性尿失禁的疗效.方法2003年7月至2004年5月在女性尿失禁特需门诊确诊为压力性尿失禁的老年患者70例,根据患者的情况分别采用经阴道尿道中段悬带成型术、经阴道无张力尿道中段悬吊术、经闭孔无张力尿道中段悬吊术、尿道中段童式前路悬吊术及尿道中段童式前路悬吊+阴道前壁膨出桥式补片修补术治疗.对术中情况进行分析及治疗后的效果进行定期随访.结果平均手术时间48 min,平均出血量70 ml,无术中并发症.70例中,60例患者术后去除导尿管后能自行排尿,术后48 h出院;10例术后出现短暂尿潴留后再留置导尿48 h后排尿正常.出院时,70例中有63例主观完全治愈.67例得到1～6个月的随访,61例主观感觉治愈,3例明显改善.随访最长6个月无复发及并发症.结论针对不同条件的压力性尿失禁老年患者选择相应的手术方法治疗安全、有效,但其远期疗效及并发症有待于进一步观察.Objective To evaluate the operation effect of intravaginal slingplasty(IVS)、tension free vaginal tape(TVT)、tension free vaginal tape obturator(TVT O)、and Tong′s hammock for the elderly woman stress urinary continence Methods From July 2003 to May 2004, 70 elderly women with stress urinary incontinence were operated under local or extradural anesthesia The patients were followed up and operative effect was evaluated on 1,3,6, 12 months after operation Results Twenty two patients were operated with IVS or TVT, 3 patients with TVT O, 30 with Tong′s hammock posterior and 15 with Tong′s hammock posterior + anterior and posterior repair were done Operation time was 19 90 min with its average of 48 min The lost blood was 10 250 ml with average of 70 ml No patients were injured in blood vessel,nerve,urethra,bladder,bladder neck during operation Sixty patients were able to micturate spontaneously after operation and discharged on the next day In the remaining 10 cases,a retained catheter had to be used for 48 hours because of temporal urine retention According to patients′self assessment,63 of 70 patients were satisfied,and felt cured Seven patients with apoplexy and DM had slight leakage of urine when they were discharged, but 4 of 7 patients obviously after one month Sixty seven patients were followed up for 1 to 6 months, 61 patients cured and 3 patients recovered There were no complications of urine retention, infection or bladder dysfunction Conclusions It is safe and effective that patients with stress urinary incontinence are treated with proper operative methods according to different patients But it must be followed up several years for evaluation

关 键 词：压力性尿失禁 手术治疗 老年女性 经阴道无张力尿道中段悬吊术 疗效分析 2003年7月 阴道前壁膨出 平均手术时间 老年患者 女性尿失禁 2004年 平均出血量 术中并发症 特需门诊 定期随访 自行排尿 留置导尿 主观感觉 治疗安全 

分 类 号：R699[医药卫生—泌尿科学]