经闭孔尿道中段无张力悬吊术治疗女性压力性尿失禁的临床分析

发布时间：2018-03-02 10:30

本文关键词： 压力性尿失禁 TVT-O 治疗生活质量　出处：《广西医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：探讨经闭孔尿道中段无张力悬吊术(TVT-O)治疗女性压力性尿失禁临床疗效及安全性。方法：分析在2012年8月至2013年11月因压力性尿失禁在广西医科大学第一附属医院西院妇产科住院行TVT-O的7例患者,记录其一般资料、手术时间、术中出血量、术后留置尿管时间、术后住院天数及并发症等情况。患者于手术前一周及术后3个月完成国际尿失禁咨询委员会尿失禁问卷简表(ICI-Q-SF)、尿失禁生活质量量表(I-QOL)。其中I-QOL分为行为限制、心理影响、社会障碍三部分,其分值越高表示患者生活质量越高。结果：(1)7例患者均手术顺利,术中未发生严重并发症,平均手术时间(24.3±6.7) min (15-30min),平均出血量(16.4±8.5)ml(10～30ml),平均术后住院天数(5.3±0.8)d(5-7d),平均术后留置尿管时间(6.3±3.4)d(5～14d)；(2)1例(14.3%)患者术后早期发生排尿困难,经药物及物理对症治疗后恢复正常排尿,未见有闭孔血肿、切口愈合不良、膀胱过度活动症(OAB)、阴道切口不适、吊带暴露、大腿根部慢性疼痛、尿路感染等并发症发生；(3)治愈者7例(100%),术后ICI-Q-SF评分较术前明显下降,差异有统计学意义(P0.05),术后I-QOL评分较术前明显升高,差异有统计学意义(P0.05)。结论：(1) TVT-O治疗女性压力性尿失禁具有治愈率高、安全、手术时间短、微创等优点；(2) TVT-O术后患者生活质量有显著改善,近期疗效满意,长期疗效及并发症仍有待进一步随访观察。
[Abstract]:Objective: to evaluate the efficacy and safety of TVT-O in the treatment of female stress urinary incontinence. Methods: from August 2012 to November 2013, 7 patients who underwent TVT-O in gynecology and obstetrics department of the first affiliated Hospital of Guangxi Medical University due to stress urinary incontinence were analyzed. The general data, operation time and intraoperative bleeding volume were recorded. The time of indwelling urinary catheter, the days of hospitalization and complications after operation. The incontinence questionnaire of the International urinary incontinence Advisory Committee was completed in the first week before operation and 3 months after operation. The ICI-Q-SFN, the quality of life scale of urinary incontinence, and the quality of life scale of urinary incontinence, among which I-QOL was divided into behavioral limitation, were included in the summary of urinary incontinence questionnaire of International urinary Incontinence Advisory Committee. The higher the score, the higher the patient's quality of life. Results the operation was successful in all 7 patients. There were no serious complications in the operation. The average operation time was 24. 3 卤6. 7 min. The average blood loss was 16. 4 卤8. 5 min / 1030ml / L, the average postoperative hospitalization time was 5. 3 卤0. 8 / d ~ 5 ~ 7 / d and the mean time of indwelling urinary catheter was 6. 3 卤3. 4 / 514 / d and 14. 3% respectively) the patients had difficulty in urination early after operation. After medication and physical therapy, normal urination, no obturator hematoma, poor wound healing, bladder hyperactivity syndrome, vaginal incision discomfort, sling exposure, and chronic pain in the root of thigh were found. Complications such as urinary tract infection occurred in 7 cases. The ICI-Q-SF score after operation was significantly lower than that before operation (P 0.05), and the I-QOL score after operation was significantly higher than that before operation (P 0.05). Conclusion TVT-O has the advantages of high cure rate, safety, short operation time and minimally invasive treatment for female stress urinary incontinence. The quality of life of the patients after TVT-O is significantly improved and the short-term curative effect is satisfactory. The long-term curative effect and complication still need to be further followed up.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R713

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