经闭孔无张力尿道中段吊带术治疗女性压力性尿失禁的效果及影响术后排尿功能恢复时间的因素分析  

Analysis of the efficacy of external-to-internal trans-obturator tape in the treatment of stress urinary incontinence in women and the related factors affecting the recovery time of postoperative voiding function

作　　者：常雪峰 丁利 耿向阳 杨佳佳[1] 王肖 杜永强 CHANG Xuefeng;DING Li;GENG Xiangyang;YANG Jiajia;WANG Xiao;DU Yongqiang(Department of Urology,Fuyang People′s Hospital,Anhui Medical University(Fuyang People′s Hospital),Anhui Province,Fuyang236000,China)

机构地区：[1]安徽医科大学附属阜阳人民医院(阜阳市人民医院)泌尿外科,安徽阜阳236000

出　　处：《中国当代医药》2022年第13期91-95,共5页China Modern Medicine

摘　　要：目的探讨由外向内经闭孔无张力尿道中段悬吊术(TOT)对女性压力性尿失禁(SUI)的治疗效果及安全性,并对影响术后排尿功能恢复时间的因素进行分析。方法回顾性选取2015年1月至2021年8月安徽医科大学附属阜阳人民医院收治的114例SUI女性患者作为研究对象,根据不同的手术方法分为观察组(63例)和对照组(51例)。观察组采用TOT方法,对照组采用由内向外经闭孔无张力尿道中段悬吊(TVT-O)方法。分析两组患者的手术治疗效果、术中指标情况和术后并发症,并对影响观察组术后排尿功能恢复时间的因素进行分析。结果两组的治疗总有效率比较,差异无统计学意义(P>0.05);两组的术中出血量、手术时间和术后住院时间比较,差异无统计学意义(P>0.05);观察组的术后并发症总发生率低于对照组,差异有统计学意义(P<0.05);年龄、绝经、尿道内括约肌功能缺陷、尿道高活动性、术前残余尿量、最大尿流率均是女性SUI患者TOT术后排尿功能恢复时间的独立影响因素(P<0.05)。结论TOT和TVT-O两种术式治疗SUI具有同样疗效,但TOT术式更安全;TOT术后排尿功能恢复时间受多重因素影响,临床可以采取相应的干预措施,以促进患者更快地恢复正常排尿功能。Objective To investigate the efficacy and safety of the treatment of female stress urinary incontinence(SUI)by external-to-internal trans-obturator tape(TOT),and to analyse the factors affecting the recovery of postoperative voiding function.Methods A total of 114 female patients with SUI treated in Fuyang People′s Hospital Affiliated to Anhui Medical University from January 2015 to August 2021 were retrospectively selected as the research objects.They were divided into the observation group(63 cases)and the control group(51 cases)according to different surgical methods.The observation group was given TOT method,and the control group was given tension-free vaginal tape-obturator technique(TVT-O)method.The patients′surgical treatment results,intraoperative indexes and postoperative complications were analyzed,and the factors affecting the recovery time of urinary function after surgery in the observation group were analyzed.Results There was no significant difference in the total effective rate between the two groups(P>0.05).There were no significant differences in the intraoperative bleeding,operation time and postoperative hospital stay between the two groups(P>0.05).The overall incidence of postoperative complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Age,menopause,internal urethral sphincter function defect,high urethral activity,preoperative residual urine volume,and maximum urinary flow rate were all independent influencing factors on the recovery time of voiding function after TOT in female SUI patients(P<0.05).Conclusion Both TOT and TVT-O have the same efficacy in the treatment of SUI,but TOT is safer.The recovery time of micturition function after TOT is affected by multiple factors.Corresponding clinical intervention measures can be taken to promote patients to recover normal micturition function faster.

关 键 词：经闭孔无张力尿道中段悬吊术 压力性尿失禁 疗效 并发症 排尿功能恢复时间 

分 类 号：R695.1[医药卫生—泌尿科学]