TVT-O治疗女性压力性尿失禁130例临床观察  

Clinical observation of the tension-free vaginal tape-obturator treatment for 130 cases of femalestress urinary incontinence

作　　者：盛慧娟[1] 韩克[2] 翁时秋[1] 卫中庆[3] 谢玉莲[2] 

机构地区：[1]南京中医药大学附属昆山中医院妇科,江苏省昆山215300 [2]南京大学附属鼓楼医院妇产科 [3]南京医科大学第二附属医院泌尿外科

出　　处：《中国医师杂志》2013年第5期613-616,共4页Journal of Chinese Physician

摘　　要：目的探讨经闭孔阴道无张力尿道中段悬吊术（ tension-free vaginal tape-obturator, TVT-O）治疗女性压力性尿失禁（ stress urinary incontinence, SUI）的临床疗效、术后并发症及其对手术安全性及生活质量的影响。方法对130例女性SUI患者行TVT-0治疗。对患者围手术期情况、术后并发症、手术前后生活质量的随访情况进行对比分析。结果130例患者全部顺利完成手术，手术时间（47．01±18．82）min，术中出血量（64．38±99．62）ml，留置导尿（2．67±0．90）d，住院时间（4．73±2．14）d。术后完成随访101例，随访率为77．7％，其术后IIQ-7评分[（1．59±4．37）分]显著低于术前[（15．74±3．87）分，Z=-8．601，P〈0．01]，术后UDI-6评分[（1．63±2．66）分]显著低于术前[（10．51±3．70）分，Z=-8．549，P〈0．01]。患者术后尿失禁主观完全治愈73例（72．3％），主观改善明显11例（10．9％），术后无效6例（5．9％）；尿垫使用13例（12．9％）；术后出现网片暴露侵蚀2例（2．0％）；术后性生活有不适感8例（7．9％）。结论TVT-O治疗女性SUI，操作简便、并发症少、安全性高，术后复发率低，患者生活质量明显提高，对盆底功能重建治疗具有积极意义。网片并发症不可忽视，需要进一步探讨。Objective To observe the clinical short- and long-term curative effect of the surgical treatment of female stress urinary incontinence （ SUI ） with tension-free vaginal tape-obturator （ TVT-O ） treatment, and discuss the safety of the operation and postoperative quality of life. Methods The data were collected from 130 patients with SUI who were underwent TVT-O treatment. The patients＇perioperative peri- od, follow-up of postoperative complications, and comparison of the quality of life before and after surgery were analyzed retrospectively. Results A total of 130 patients was successfully completed their surgeries with a mean operative time （47.01 ± 18. 82）min, average blood loss （64. 38 ＋ 99. 62 ）ml, mean catheter- ization （2. 67 ±0. 90）d, and the average length of stay （4. 73 ±2. 14）d. A total of 101 cases was comple- ted the postoperative follow-up with （a） preoperative quality of life in patients with IIQ-7 score 6 to 21 points and an average of （ 15.74 ± 3.87 ） rain, （b） symptoms of lower urinary tract UDI-6 score of 3 to 22 minutes and the average （10. 51 ± 3.70）min, （c） postoperative quality of life improved significantly IIQ-7 score from 0 to 21 points and an average of （1.59 ±4. 37）points, and （e） UDI-6 score 0 to 14 points and an average of （ 1.63 ±2. 66） points. A total of 73 patients （72. 3% ） had the postoperative urinary inconti- nence, which subjective symptom were completely cured, significant improvement was 11 cases （ 10. 9% ） , ineffectiveness was 6 cases （5.9%）, pad using was 13 patients （ 12. 9% ）, vaginal mesh exposure and ero- sion was 2 patients（2. 0% ）, the sexual life postoperatively was affected in 8 patients （7.9%）. Conclu- sions TVT-O treatment of SUI is not only easy to operate but also has clinically high security, few compli- cations, low recurrence rate, and significantly improved patients＇living quantities. However, patch compli-cations can not be ignored and need further discussion.

关 键 词：肌张力 尿失禁 压力性 外科学 阴道 外科学 治疗结果 随访研究 手术后并发 症 生活质量 

分 类 号：R694.5[医药卫生—泌尿科学]