新式阴道前壁补片修补术治疗压力性尿失禁女性患者的疗效分析  

A new vaginal antetheca-retropubic mesh-repair for stress urinary incontinence female patients

作　　者：袁峥[1] 尹格平[1] 李娟[1] 刘娜[1] 梁静[1] 武爱芳[1] 

机构地区：[1]济南军区总医院妇科,250031

出　　处：《中华妇幼临床医学杂志（电子版）》2017年第2期194-198,共5页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：济南军区卫生部基金资助项目(2013ZX05)~~

摘　　要：目的探讨阴道前壁黏膜下双侧耻骨后间隙造穴植入生物补片修补术(简称为新式阴道前壁补片修补术),对压力性尿失禁(SUI)女性患者的近、远期手术疗效。方法选择2009年1月至2014年12月,在济南军区总医院诊断为SUI,并行新式阴道前壁补片修补术治疗的316例女性患者为研究对象,并对其随访≥12个月。本术式中使用本研究设计并获中国实用新式专利的"YGP-Ⅱ型阴道前壁穴道分离补片放置复合钳"。采用《国际尿失禁咨询委员会尿失禁问卷简表》(ICIQ-SF)进行疗效主观评价,采用尿垫试验进行疗效客观评价。分析患者手术情况及术后并发症等临床资料,统计学分析该术式近、远期疗效。本手术及研究遵循的程序,得到济南军区总医院医学伦理委员会批准,并取得患者知情同意。结果 (1)本研究中度SUI患者为264例,重度SUI患者为52例;平均手术时间为(15.7±4.2)min,术中平均出血量为(69.1±26.9)mL,术后平均住院时间为(1.9±1.7)d。(2)术后并发症包括排尿不尽、发热、小便困难、尿路感染及补片外露等,术后无严重并发症发生。(3)中度或重度SUI女性患者,术前ICIQ-SF评分均较术后12个月高,并且差异均有统计学意义(t=12.569,14.028;P<0.001);术后随访12个月患者的SUI治愈率(91.8%)与随访≥24个月的治愈率(94.2%)比较,差异无统计学意义(χ2=1.020,P=0.211)。结论本新式阴道前壁补片修补术,治疗中、重度SUI女性患者有效,远期疗效可靠,并且更微创化,是否适于临床推广应用,尚需多中心、大样本随机对照试验进一步研究、证实。ObjectiveTo investigate the short and long term effects of vaginal antetheca submucosal-retropubic space with mesh-repair through the implantation of biological patch （shortly as new-style vaginal mesh repair） in the treatment of the female patients with stress urinary incontinence （SUI）.MethodsFrom January 2009 to December 2014, 316 female patients diagnosed as SUI and with the treatment of new-style vaginal mesh repair in Jinan Military General Hospital, were chosen as study subjects, and were followed up more than 12 months. The special designed Chinese utility model patent named ＂ YGP-Ⅱ type of composite clamp for anterior vaginal wall acupoint patch separation and patch placement＂ was used in this technique in this research. The International Consultation on Incontinence Questionnaire Short Form （ICIQ-SF） was used for subjective evaluation of curative effects, and the urine pad test was used for objective evaluation. The clinical data of surgery condition and postoperative complications of these patients, and short and long term curative effects of this operation were statistically analyzed. The operation and research procedures were approved by the Ethics Committee of Jinan Military General Hospital, and obtained the informed consent of each patient.Results①There were 264 cases of moderate SUI and 52 cases of severe SUI in this study. The average operation time was （15.7±4.2） min, the average intraoperative bleeding volume was （69.1±26.9） mL, and the average stay of hospitalization was （1.9±1.7） d. ②Postoperative complications included sensation of not emptying bladder completely finished urinating, fever, dysuria, urinary tract infection and exposure of the patch, and no serious complications were found. ③In female patients with moderate or severe SUI, preoperative ICIQ-SF scores were higher than that of 12 months after surgery, and the differences were statistically significant （t=12.569, 14.028; P〈0.001）. There was no significant difference of SUI recovery rat

关 键 词：尿失禁 压力性 治疗结果 阴道前壁黏膜下-耻骨后间隙补片修补术 妇女 

分 类 号：R713[医药卫生—妇产科学]