阴道无张力尿道中段悬吊术远期临床结局探讨  

Study on the Long-term Efficacy of Tension-free Vaginal Tape(TVT) for the Treatment of Stress Urinary Incontinence(SUI)

作　　者：孙智晶[1] 朱兰[1] 郎景和[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,北京100730

出　　处：《实用妇产科杂志》2008年第6期353-355,共3页Journal of Practical Obstetrics and Gynecology

基　　金：十一五科技支撑项目(2007BAI04B05)

摘　　要：目的:探讨阴道无张力尿道中段悬吊术(TVT)的远期临床结局。方法:选择2001年9月至2004年10月我院行TVT术后3年以上患者45例,进行主观治疗结果、手术满意情况及术后远期并发症的调查。并应用尿失禁患者生活质量问卷(I-QOL)和盆腔器官脱垂、尿失禁患者性功能(PISQ)问卷,对患者手术前后生活质量、性生活质量进行评分。结果:39例患者回答问卷,问卷回复率为86.7%(39/45)。39例患者平均随访54.4±1.5个月,主观治愈率为84.6%(33/39),主观改善率为10.3%(4/39)。手术失败率为5.1%(2/39)。手术满意率(治愈加改善)94.9%(37/39)。1例患者(2.6%)术后反复发生泌尿系感染,无其他远期并发症发生。I-QOL评分术前术后比较,差异有非常显著性(P<0.01);PISQ评分术前术后比较差异无显著性(P>0.05)。性生活(术后PISQ评分增加者)改善率为54.8%。结论:TVT术治疗女性压力性尿失禁的远期疗效确切,可以显著改善患者生活质量,对性生活质量无负面影响。Objective：To describe the long - term clinical outcome of tension - free vaginal tape （TVT） for the treatment of stress urinary incontinence （SUI）.Methods-A total of forty-five cases of women who had undergone TVT surgery more than 3 years were included, The subjective cure rate, patients＇ satisfaction, and postoperative complications were analyzed, Incontinence quality of life （I- QOL） and pelvic organ prolapse - urinary incontinence sexual function questionnaire （PISQ） were evaluated and compared their preoperative and postoperative scores, Results： Thirty- nine patients answered the questionnaires giving a follow- up rate of 86.7%, Mean follow -up time was 54.4± 1.5 months. The subjective cure/improved rates were 84.6% and 10.3%, respectively, A satisfaction rate （cure and improved） was 94.9%, Two patients had recurrent SUI in postoperative 28 and 36 months, respectively, There were no other complications but a recuprent urinary tract infection associated with voiding difficulties, The average score of I - QOL was 31.5 ± 18.8 and 88.5 ± 18.1 before and after surgery, and there was significant difference （ P 〈 0.01 ）, The average score of PISQ was 81.5 ± 15.4 and 83.1 ± 16.0 before and after the surgery, and there was no significant difference （ P〉 0.05）, But the sexual function improvement ratio was 54.8%, Conclusions-TVT is an effective and safe procedure for SUI with high success rates in the long - term follow- up. It improved the patients＇ quality of life evidently and has no adverse effect on their sexual life.

关 键 词：阴道无张力尿道中段悬吊术 远期临床结局 生活质量 性生活质量 

分 类 号：R711[医药卫生—妇产科学]