TVT-O联合阴道雌激素治疗高龄产妇产后压力性尿失禁的治疗效果和临床价值  

Efficacy and clinical significance of TVT-O combined with vaginal estrogen in treatment of postpartum stress urinary incontinence in elderly parturients

作　　者：章淑云 田圆圆[1] ZHANG Shuyun;TIAN Yuanyuan(Department of Gynaecology and Obstetrics,Changxing County Maternal and Child Health Hospital,Huzhou 313105,China)

机构地区：[1]浙江省长兴县妇幼保健院妇产科,湖州313105

出　　处：《中国临床药学杂志》2023年第4期272-277,共6页Chinese Journal of Clinical Pharmacy

摘　　要：目的 探讨经闭孔无张力尿道中段悬吊术(TVT-O)联合使用阴道雌激素在高龄产妇产后压力性尿失禁(SUI)中的治疗效果和临床价值。方法 回顾性分析90例产后SUI高龄产妇,随机分为A组和B组,各45例。A组采用TVT-O联合阴道雌激素治疗,B组采用经耻骨后阴道无张力尿道悬吊术(TVT)联合阴道雌激素治疗,观察比较2组手术指标、术后并发症及联合治疗疗效、治疗前后尿动力学、盆底功能、生活质量及焦虑情绪的变化。结果 A组手术时间、术中出血量、住院时间及术后并发症发生率均显著低于B组(P <0.01)。A组和B组治疗总有效率分别为95.56%和82.22%,A组显著高于B组(P <0.01)。治疗后A组和B组的各项尿动力学指标均较治疗前升高,且A组显著高于B组(P <0.05)。此外,A组的盆底功能障碍问卷(PF-DI-20)、尿失禁生活质量问卷(I-QOL)和焦虑自评量表(SAS)评分降低或升高的幅度均大于B组。结论 TVT-O联合阴道雌激素治疗SUI的创伤小、术后并发症少,治疗效果显著,可明显改善高龄产妇产后SUI患者的盆底功能、尿动力学、生活质量和焦虑情绪,利于康复。AIM To study the therapeutic effect and clinical value of transobturator tension-free mid urethral suspension(TVT-O)combined with vaginal estrogen in elderly parturients with postpartum stress urinary incontinence(SUI).METHODS Retrospective analysis was made on 90 elderly parturients with postpartum SUI admitted to our hospital.They were randomly divided into group A and group B,with 45 patients in each group.Group A was treated with TVT-O combined with vaginal estrogen,and group B was treated with transpubic vaginal tension-free urethral suspension(TVT) combined with vaginal estrogen.The surgical indexes,postoperative complications,combined treatment effect,urodynamics,pelvic floor function,quality of life,and changes of anxiety were observed and compared between 2 groups.RESULTS The operation time,intraoperative blood loss,hospital stay and postoperative complication rate in group A were significantly lower than those in group B(P<0.01).The total effective rates of group A and group B were 95.56%and 82.22%,respectively,which were significantly higher in group A than in group B(P<0.01).After treatment,the urodynamic indexes of group A and group B were higher than before treatment,and those of group A were significantly higher than group B(P<0.05).In addition,the scores of pelvic floor dysfunction questionnaire(PF-DI-20),urinary incontinence quality of life questionnaire(I-QOL) and self rating anxiety scale(SAS) in group A decreased or increased more than those in group B.CONCLUSION TVT-O combined with vaginal estrogen can significantly improve the pelvic floor function,urodynamics,quality of life and anxiety of the elderly postpartum SUI patients,and promote rehabilitation.

关 键 词：经闭孔无张力尿道中段悬吊术 雌激素 压力性尿失禁 盆底功能 焦虑情绪 

分 类 号：R711.59[医药卫生—妇产科学]