阴道无张力尿道中段悬吊术治疗压力性尿失禁临床疗效观察  

Tension-free vaginal tape for surgical treatment of female stress urinary incontinence

作　　者：朱兰[1] 郎景和[1] 史宏晖[1] 肖河[2] 李永强[2] 李汉忠[2] 李春艳[1] 

机构地区：[1]中国医学科学院／中国协和医科大学／北京协和医院妇产科,100730 [2]中国医学科学院／中国协和医科大学／北京协和医院泌尿科,100730

出　　处：《疑难病杂志》2008年第5期279-281,共3页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探讨阴道无张力尿道中段悬吊术(TVT)治疗压力性尿失禁的远期效果。方法60例患者经尿动力学证实为压力性尿失禁(其中4例为混合性尿失禁),同时伴有不同程度阴道前壁膨出,均进行了TVT术及相关妇科手术,采用标准化前瞻、开放研究对术前、术后进行评估。结果单纯行TVT中位手术时间27.52min,术中中位出血量为26.12ml,中位住院天数1.86d;未发生术中严重并发症,16.7%患者发生尿潴留的近期并发症;患者年龄≥50岁组比<50岁组易发生尿潴留(P<0.01);3.3%发生远期并发症;其他妇科手术与TVT术同时进行无术后病率的发生;以患者主观感觉评价,96.7%患者治愈,3.3%改善明显,无无效病例,随着时间的推移,未见有复发的征兆。结论TVT术是治疗压力性尿失禁的一种微创、安全和有效的手术方法,其他妇科手术与TVT术同时操作是可行的。Objective To investigate the long-term therapeutic effect of tension-free vaginal tape （TVT）, a new surgical procedure for treatment of female stress urinary incontinence. Methods Sixty female with stress urinary incontinence confirmed by urodynamics accompanied with pelvic organ prolapse underwent TVT and related gynecolog- ic procedures. Open and prospective research was performed standardly to evaluate the pre and post operation conditions of all patients. Results Mean TVT operation time was 27.52 minutes. Mean intraoperative blood loss was 26.12 ml and average hospital stay was 1.86 days. As a short-term complication, urine retention was observed in 16.7% patients with a significantly higher rate in patients ≥50 years old than those 〈 50 （ P 〈 0.01 ）. No serious intraoperative complication was observed. Long-term complication was observed in 3.3% patients. No postoperative morbidity was observed in patients with TVT and related gynecologic procedure. The recovery rate was 96.7 % according to the patients＇ subjective symptoms and no one failed. No recurrence was observed in all the patients. Conclusion It has been proved that TVT procedure is one of minimal invasive, effective and safe surgery for treatment of female stress urinary incontinence. Related gynecologic procedure is feasible accompanied with TVT was performed.

关 键 词：压力性尿失禁 阴道无张力尿道中段悬吊术 临床疗效 

分 类 号：R699[医药卫生—泌尿科学]