单切口经阴道无张力尿道中段悬吊术(TVT-S)H和U两种术式的疗效及并发症的系统评价  

Systematic evaluation of the efficacy and safety of H-type versus U-type method in TVT-Secur

作　　者：张玲 吴铁林 姚晔俪[2] 

机构地区：[1]宁波明州医院妇产科,浙江宁波315100 [2]浙江大学医学院附属妇产科医院妇产科,浙江杭州310006

出　　处：《中国现代医生》2014年第12期20-23,81,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2013KYB147)

摘　　要：目的 系统评价单切口经阴道尿道中段悬吊术（TVT-S）H和U两种术式的疗效及并发症差异.方法 计算机配合手工检索万方数据库、CNKI、CBM、VIP、EM-BASE、Google-scholar、MEDLINE、OVID、FMJS、PUBMED、CochraneLibrary中,从2006年1月～2013年1月有关TVT-S的包含H和U疗效比较的文献并提取相关数据进行统计学分析.结果 最终纳入8篇文献,共959名患者接受了TVT-S手术,手术方式包括H和U途径.其中H和U途径的客观治愈率分别为79.6％、80.2％ （P=0.850）,主观治愈率分别为74.9％和75.1％（P=0.960）.阴道穿孔发生率H组为2.8％,U组为0（P=0.001）,术后尿潴留发生率H组为2.1％,U组为2.8％ （P=0.564）.术后吊带暴露相关并发症两组合计发生率为2.4％,合计有6.1％的患者术后随访过程中尿失禁复发,8.7％的患者出现了术后新发的尿道刺激症状.结论 TVT-S术式操作简单,但治愈率整体不高,且H和U术式之间的疗效及除阴道穿孔以外的并发症差异并没有统计学意义,有必要进一步研究和设计新的手术方式及材料.Objective To compare the cure rate and operative complications between U-type and H-type methods of TVT-Secur （TVT-S） by means of a systematic review and meta analysis. Methods Literature searches were conducted for all comparing U-type and H-type methods from WANFANG, CNKI, CBM, VIP, EM-BASE, Google-scholar, MED- LINE, OVID, FMJS, PUBMED, CochraneLibrary from January 2006 to January 2013. Results A total of 959 females in 8 trails were included. The operative method includes H and U. The objective cure rate was 79.6% and 80.2%（P= 0.850） respectively in H group and U group. The subjective cure rate was 74.9% in H group and 75.1% in U group （P=0.960）. Vaginal wall perforation rate was 2.8% in H group and 0 in U group （P=0.001）. Postoperative urine retention rate was 2.1% and 2.8% respectively in H group and U group（P=0.564）. About 2.4% of all the patients had tape expo- sure problem. The recurrence rate was 6.1% and de novo OAB rate was 8.7% in all of these patients. Conclusion The procedure of TVT-S is simple. However, the efficacy of the TVT-S is lower than the cure rates reported for other TVT procedures; further studies are required.

关 键 词：尿失禁 TVT-S 随机对照试验 

分 类 号：R699[医药卫生—泌尿科学]