经阴道和经腹术式治疗膀胱阴道瘘的疗效观察  

Comparison of transvaginal repair and transabdominal repair for vesicovaginal fistula

作　　者：唐渊[1] 虞巍[1] 肖云翔[1] 吴士良[1] 杨勇[2] 周利群[1] 金杰[1] 

机构地区：[1]北京大学第一医院泌尿外科北京大学泌尿外科研究所,100034 [2]北京大学肿瘤医院泌尿外科

出　　处：《中华泌尿外科杂志》2014年第1期54-57,共4页Chinese Journal of Urology

摘　　要：目的 对比分析经阴道和经腹术式治疗膀胱阴道瘘的疗效. 方法 回顾性分析北京大学第一医院泌尿外科2001年1月至2011年12月收治的72例膀胱阴道瘘患者的临床资料.57例接受手术修补,其中经阴道膀胱阴道瘘修补39例、经腹部膀胱阴道瘘修补18例,两组患者的年龄、瘘口大小、位置等基线状况比较差异均无统计学意义（P＞0.05）.比较两种手术方式在修补成功率、手术时间、住院时间等方面的差异.随访时间为3个月 结果 经阴道修补组手术时间为（142±35） min,经腹修补组为（212±79） min,组间比较差异有统计学意义（t＇=-3.592,P=0.002）.经阴道修补组术后住院时间（14±6）d,经腹修补组（27±10）d,组间比较差异有统计学意义（t＇=-4.983,P=0.000）.经阴道修补组成功率为95％ （37/39）,经腹修补组为72％（13/18）,组间比较差异有统计学意义（p=0.027）. 结论 针对常见的不合并输尿管损伤的膀胱阴道瘘,经阴道修补手术方法成功率高,术后恢复快,更符合微创手术观念,是一种值得推广的手术修补方式.Objective To compare the outcome of transvaginal repair of vesicovaginal fistula with that of transabdominal repair.Methods A total of 72 patients were managed for vesicovaginal fistula between January 2001 and December 2011.Fifty-seven cases underwent surgical repair,39 of which were repaired by a vaginal approach using flap splitting techniques,18 of which underwent transabdominal repair.The baseline statuses of the 2 group were equal.After 3 months of follow-up,the operative and outcome data were abstracted and analyzed with statistical methods.Results Transvaginal repair could result in a significantly higher success rate than transabdominal procedure （95％ versus 72％,P=0.027）.The transvaginal operative time was shorter than transabdominal ones （142± 35 min versus 212± 79 min,t＇ =-3.592,P =0.002）.The postoperative hospital stay of transvaginal group was also shorter than that of transvaginal group （14±6 d versus 27±10 d,t＇=-4.983,P=0.000）.Conclusion For simple vesicovaginal fistula,transvaginal repair could be a minimal invasive procedure,and provide favorable outcomes.

关 键 词：膀胱阴道瘘 经阴道修补术 经腹修补术 治疗结果 

分 类 号：R699[医药卫生—泌尿科学]