两种术式治疗女性压力性尿失禁的临床疗效及安全性对比  

Comparison of efficacy and safety of two types of surgical treatment for female stress urinary incontinence

作　　者：吴梦婷 罗琰 陈高文[1] 李肖璇[1] 韩娜娜 王沂峰[1] WU Mengting;LUO Yan;CHEN Gaowen;LI Xiaoxuan;HAN Nana;WANG Yifeng(ZhuJiang Hospital of Southern Medical University,Guangzhou,Guangdong 510260,China)

机构地区：[1]南方医科大学珠江医院妇产科,广州510260

出　　处：《中国妇产科临床杂志》2022年第6期591-594,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：广东省自然科学基金(2021A1515011638)。

摘　　要：目的比较耻骨降支无张力尿道中段悬吊术(tension-free vaginal tape-ischiopubic ramus,TVT-IR)与经闭孔无张力尿道中段吊带术(tension-free vaginal tape-obturator,TVT-O)对治疗女性压力性尿失禁(stress urinary incontinence,SUI)的临床疗效及安全性。方法回顾性分析36例女性SUI患者的临床资料,根据手术方式不同分为TVT-IR组(n=17)和TVT-O组(n=19),比较两组围手术期指标、并发症、临床疗效与患者满意度。结果TVT-IR组的手术时间[(26.290±2.257)min]低于TVT-O组[(37.260±6.632)min];TVT-O组术中神经损伤1例,TVT-IR组无神经损伤。TVT-IR组住院时间[(8.240±1.562)d]与TVT-O组[(8.210±2.720)d]比较,差异无统计学意义(P>0.05)。TVT-IR组总住院费用[(21396.514±7538.688)元]与TVT-O组[(40144.661±70304.670)元]比较,差异无统计学意义(P>0.05)。两组术后6个月均有2例患者尿失禁复发,差异无统计学意义(P>0.05)。TVT-O组1例患者在术后1年内发生吊带侵蚀。两组术后1年的手术疗效、术后并发症发生率及患者满意度比较,差异无统计学意义(P>0.05)。结论TVT-IR与TVT-O临床疗效及并发症相当,但TVT-IR手术简便,手术时间更短,值得临床推广。Objective To explore the efficacy and safety of tension-free vaginal tape-ischiopubic ramus(TVT-IR)and tension-free vaginal tape-obturator(TVT-O)in the treatment of female stress urinary incontinence(SUI).Methods The clinical data of 36 female SUI patients were retrospectively analyzed,and they were divided into TVT-IR group(n=17)and TVT-O group(n=19)according to different surgical methods.The surgical indicators,complications,clinical efficacy and patient satisfaction of the two groups were compared.Results The operation time of the TVT-IR group[(26.290±2.257)min]was lower than that of the TVT-O group[(37.260±6.632)min].There was one case of nerve injury in the TVT-O group,but no neurological injury in the TVT-IR.The length of stay in the TVT-IR group[(8.240±1.562)days]was similar to that in the TVT-O group[(8.210±2.720)days],and the difference was not statistically significant(P>0.05).The total hospitalization cost of TVT-IR group[(21396.514±7538.688)RMB]was lower than that of the TVT-O group[(40144.661±70304.670)RMB],and the difference was not statistically significant(P>0.05).There were of urinary incontinence in both groups within 6 months after surgery,with no statistical significance(P>0.05).One case developed sling erosion within 1 year after surgery in the TVT-O group.There were no significant differences in surgical efficacy,incidence of postoperative complications and patient satisfaction between the two groups within one year after surgery(P>0.05).Conclusions The efficacy and complications of TVT-IR and TVT-O surgery are similar.However,TVT-IR has the advantages of simple operation,shorter operation time,which is worthy of clinical application.

关 键 词：压力性尿失禁 耻骨降支无张力尿道中段悬吊术 经闭孔无张力尿道中段吊带术 疗效 安全性 

分 类 号：R713[医药卫生—妇产科学]