经闭孔无张力尿道吊带术治疗女性压力性尿失禁的疗效与安全性分析  

Efficacy and safety of tension free vaginal tape obturator technique in females stress urinary incontinence

作　　者：张耀光[1] 魏东[1] 王建业[1] 万奔[1] 刘明[1] 王建龙[1] 张亚群[1] 金滨[1] 伍建业[1] 王飞[1] 贾宝明[2] 

机构地区：[1]卫生部北京医院泌尿外科,100730 [2]山西省太谷县人民医院

出　　处：《中华泌尿外科杂志》2012年第9期672-674,共3页Chinese Journal of Urology

摘　　要：目的分析经闭孔无张力尿道吊带术（TVT—O）治疗女性压力性尿失禁（SUI）的临床疗效及安全性。方法2008年6月至2012年5月应用TVT—O术治疗女性SUI患者156例，年龄（56．3±13．9）岁。单纯性SUI124例（79．5％），合并急迫性尿失禁32例（20．5％）。随访2～35个月，平均16．5个月。患者均填写国际尿失禁咨询委员会尿失禁问卷简表（ICI—Q—SF）和尿失禁生活质量问卷（I-QOL），分析TVT—O术的疗效和安全性。结果156例手术均顺利，手术时间（34±11）min；估计失血量（15±9）ml。治愈145例（92．9％），症状改善8例（5．1％），总有效率98．O％。手术前后尿失禁症状评分分别为（8．2±2．1）、（0．5±1．3）分，生活质量评分分别为（28．5±10．3）、（69．8±9．9）分，手术前后比较差异有统计学意义（P〈0．05）。术中未发生膀胱损伤；阴道壁损伤2例，手术修补；术后暂时性尿潴留3例（1．9％），经留置导尿2周后好转；无盆腔血肿、长期疼痛、吊带侵蚀、感染、瘘管等并发症。结论TVT—O操作简单、微创、并发症少，是治疗女性SUI安全、有效的方法。Objective To evaluate the efficacy and safety of tension free vaginal tape obturator technique （TVT-O） in females stress urinary incontinence （SUI）. Methods From June 2008 to May 2012, 156 cases of female SUI were treated with TVT-O procedure in our hospital. The mean age is 56.3 ± 13.9 years. There were 79.5% patients who suffered simple SUI while 20.5% patients with SUI and urge urinary incontinence （UUI）. The mean follow-up time was 16.5 months. All patient＇s ICI-Q-SF scores and I-QOL scores were collected. The efficacy and safety of TVT-O were analyzed. Results The mean operative time was 34 ± 11 minutes and the mean estimated blood loss were 15 ± 9 ml. One hundred and forty-five cases were cured with TVT-O （92.9%） while 8 cases were improved （5.1% ）. The preoperative and post-operative ICI-Q-SF symptom scores were 8.2 ± 2.1 and 0.5 ± 1.3 while the I-QOL life quality scores were 28.5 ± 10.3 and 69.8 ± 9.9 respectively. There was statistical difference between the preoperative and post-operative scores （P 〈 0.05 ）. No bladder injury was recorded during the procedures. There were two cases whose vaginal wall were injured and repaired intraoperatively. No pelvic hematoma, long - term pain, sling erosion, infection and fistula were found in all cases. Three cases （ 1.9% ） suffered temporary urinary retention and were cured by two weeks urethral catheterization. Conclusions TVT-O technique seems to be an easy and minimally invasive procedure with less complication, which supports its safety and reliability in the treatment of female SUI.

关 键 词：尿失禁 压力性 女性 外科手术 选择性 

分 类 号：R699[医药卫生—泌尿科学]