中重度压力性尿失禁妇女生活质量和手术干预  

Quality of life and surgical intervention in patients with moderate or severe stress urinary incontinence

作　　者：李莉[1] 李怀芳[1] 童晓文[1] 朱新贤[1] 

机构地区：[1]同济大学附属同济医院妇产科,上海200065

出　　处：《同济大学学报（医学版）》2012年第1期100-104,共5页Journal of Tongji University(Medical Science)

摘　　要：目的了解中重度压力性尿失禁妇女生活质量状况,从生活质量角度评估手术效果,为进一步提高尿失禁患者的生活质量提供依据。方法选取2007年6月至2008年9月在同济大学附属同济医院妇产科行经闭孔无张力吊带尿道中段悬吊术(trans-obturator tension free vaginal tape,TVT-O)治疗的中重度压力性尿失禁妇女88例,采用统一设计的压力性尿失禁患者生活质量问卷进行调查。对研究对象手术前后生活质量评分、手术情况以及影响患者生活质量的因素进行深入分析。结果调查对象术前行为限制、心理影响、社会障碍3个维度的评分和生活质量平均评分分别为22.3分、29.3分、11.3分和62.8分,术后生活质量评分明显升高,各维度评分和生活质量总评分分别为35.3分、42.3分、20.8分和98.4分。TVT-O手术平均用时41.2 min,术中出血量平均33.4 ml,无术中并发症发生,平均住院7.0 d,痊愈者占95.5%,好转者占4.5%,无无效和病情加重者。结论压力性尿失禁严重影响妇女的生活质量。TVT-O手术可明显改善患者的生活质量,是一项治愈率高、并发症少、手术时间短、创伤小、患者恢复快的手术。为取得更好的治疗效果,患者应尽早治疗。Objective To evaluate the quality of life （QOL） of patients with stress urinary incontin- ence （SUI） and the efficacy of surgical intervention. Methods Eighty-eight patients with moderate or severe SU! underwent trans-obturator tension free vaginal tape （TVT-O） procedure from June 2007 to September 2008. The status of preoperative and postoperative QOL was evaluated with unified designed questionnaires and influencing factors of QOL were analyzed. Results The mean duration of SUI symptom was 8.7y, 75 % had no previous visit. The preoperative scores of QOL, behavior limitation, psychological impacts and social obstacles were 62.8, 22.3, 29.3 and 11.3. The postoperative scores were raised to 98.4, 35.3, 42.3 and 20.8, respectively. The severity of SUI, duration of SUI and maximum of delivered fetal weight were influencing factors for preoperative QOL; and the severity and duration of SUI were also influencing factors for postoperative QOL. The mean operating time and EBL were 41.2rain and 33.4ml. There were no operative complications. Mean length of hospital stay was 7.0 d. 95.5% patients were cured and 4.5% had improvement. Conclusion The symptoms of SUI seriously influence the QOL. TVT-O procedure, with high cure rate, few complications, short operating time, mini-invasion and quick recovery, can improve patients＇ QOL significantly.

关 键 词：生活质量 经闭孔无张力吊带尿道中段悬吊术 中重度压力性尿失禁 妇女 定量研究 

分 类 号：R713[医药卫生—妇产科学]