TVT-O术治疗ISD型压力性尿失禁的临床效果分析  

TVT-O procedure for female stress urinary incontinence with ISD

作　　者：秦美英 夏志军[1] Qin Meiying;Xia Zhijun(Gynecologic Department of China Medical University Affiliated Shengjing Hospital,Shenyang 110004)

机构地区：[1]中国医科大学附属盛京医院妇科盆底疾病病房,辽宁省盆底诊治中心,沈阳110004

出　　处：《现代妇产科进展》2018年第10期758-761,共4页Progress in Obstetrics and Gynecology

摘　　要：目的:研究闭孔尿道中段悬吊带术(TVT-O)治疗尿道括约肌障碍型(ISD型)和非尿道括约肌障碍型(非ISD型)压力性尿失禁(SUI)患者的临床效果,探讨划分ISD型SUI是否存在临床意义。方法:回顾分析2011年1月至2016年12月于中国医科大学附属盛京医院妇科行TVT-O术治疗的234例中重度SUI患者的临床资料,研究TVTO治疗ISD型和非ISD型SUI的手术效果。结果:234例SUI患者中有73例ISD型SUI,占31.2%,其中治愈68例(93.2%),改善5例(6.8%);非ISD型SUI患者161例,占68.8%,其中治愈154例(95.7%),改善6例(3.7%),治疗无效1例(0.6%)。TVT-O术治疗ISD型SUI和非ISD型SUI的治疗效果比较,差异无统计学意义(P> 0.05)。ISD型和非ISD型SUI患者术后主观评分较术前明显改善(P<0.05);且两组在术前术后主观评分变化方面比较,差异无统计学意义(P>0.05)。无术中出血、术后吊带侵蚀或暴露、感染的病例出现。术后3例患者出现排尿费力、尿流变细的症状,经保守治疗后缓解; 7例患者出现腹股沟区疼痛,1周后症状逐渐缓解。结论:TVT-O术在治疗ISD型SUI和非ISD型SUI的临床效果上无明显差异,具有高治愈率、低并发症的特点。理论分型在临床中对患者的治疗效果并未起差异影响。Objective:To evaluate effects of TVT-O treatment on the female stress urinary incontinence with intrinsic sphincter dysfunction and anatomic stress urinary incontinence.To explore whether it had the clinical significance to division the ISD subtype of stress urinary incontinence in clinical.Methods:234 patients of SUI treated with TVT-O procedure in China Medical University Affiliated Shengjing Hospital from Jan.2011 to Dec.2016 were retrospectively analyzed.Preoperative and postoperative outcomes of subjective evaluation form and urodynamics were studied.Results:Totally 234 patients underwent TVT-O procedures.All cases were followed up.In 73 patients with ISD,68 patients were completely cured,5 patients were improved.In 161 patients without ISD,154 were completely cured,another 6 patients were improved and one patient was regarded as failure.There were no statistical differences in the cure rate.There were statistical differences between preoperative and postoperative subjective evaluation form in both ISD and without ISD patients.No case occur erosion、exposure and infection.However,3 patients with non-ISD suffered from postoperative voiding difficulty.They recovered after conservative treatment.Seven patients developed pain in the groin area and the symptoms gradually eased after 1 week.Conclusions:TVT-O surgery has the characteristics of high cure rate and low complications in the treatment of ISD stress urinary incontinence and non-ISD stress urinary incontinence.There was no obvious difference in two groups.

关 键 词：TVT-O ISD型压力性尿失禁 非ISD型压力性尿失禁 

分 类 号：R71[医药卫生—妇产科学]