阴道前壁瓣自体移植治疗压力性尿失禁临床探讨  

Clinical Study about Homograft by Paries Anterior Vaginal Flap for Stress Urinary Incontinence Treatment

作　　者：陈涓涓[1] 夏志军[2] 许海楠[1] 秦美英 

机构地区：[1]中国医科大学研究生院,沈阳110000 [2]中国医科大学附属盛京医院妇科盆底病房,沈阳110000

出　　处：《中国医科大学学报》2013年第10期918-923,共6页Journal of China Medical University

基　　金：辽宁省自然科学基金(20102255);辽宁省科学技术计划(2012225017);国家科技部一二五重大专项课题(2012ZX09401004);沈阳市科学技术计划(F-149-9-43)

摘　　要：目的探讨采用阴道壁瓣(AVWF)自体移植至尿道中路治疗压力性尿失禁的临床疗效。方法收集压力性尿失禁患者44例,分成实验组与对照组各22人,实验组行自体移植至尿道中路手术治疗,对照组行尿道中路悬吊手术治疗。根据术后2个月、术后1年的随访,对比两种手术方式的治愈率和术后并发症。结果术后2月的术后随访调查中,实验组19例患者尿失禁症状完全治愈、2例尿失禁患者术后仍有轻度尿失禁症状,1例尿失禁患者术后症状无明显改善。治愈率为86.36%,22例患者术后均无切口部位感染、膀胱损伤、血肿、术后阴道异物暴露等并发症。对照组术后21例患者症状完全改善,治愈率为95.45%,1例患者有排尿困难症状。根据1年随访结果,实验组21例患者术后尿失禁症状完全治愈、1例尿失禁患者术后症状无明显改善。治愈率为95.45%,22例患者均无切口部位感染、膀胱损伤、血肿、术后阴道异物暴露等并发症。对照组20例患者症状完全改善,1例患者有排尿困难症状,1例患者网片暴露,治愈率为90.91%。结论与尿道中路悬吊手术比较,阴道前壁瓣移植治疗压力性尿失禁,疗效明确。该手术安全可靠,是减少异物排斥、移植物应用的一种新的治疗压力性尿失禁的手术方法。Objective To screen,identify the nerve growth promoting component in pilose antler,and evaluate its biological activity.Methods The technology platform for the evaluation of NGF biological activity was established.PC12 cells were treated with rhNGF,and then the nerve growth promoting component in fresh antler or its epidermal secretions were screened and identified.Results Mter homogenization and CM-FF ion exchange chromatography,nerve growth promoting component was identified in the elution peak Ⅱ of the fresh antler; β subunit of NGF was confirmed by Western blot analysis,which was not observed in the secretion of the antler＇ s epidermal cell culture.Conclusion The NGF-like factor was found in the fresh antler,it can promote the proliferation of PC 12 cells,which could be one of the main active components in pilose antler.

关 键 词：阴道壁皮瓣 压力性尿失禁 手术方法 自体移植 

分 类 号：R711[医药卫生—妇产科学]