TVT-O和TVT-S治疗女性压力性尿失禁的中远期疗效的Meta分析

发布时间：2018-05-15 12:58

本文选题：压力性尿失禁 + 经闭孔路径阴道无张力尿道中段悬吊术　；参考：《苏州大学》2014年硕士论文

【摘要】：[目的]评价两种手术TVT-O和TVT-S治疗女性压力性尿失禁的成功率和并发症。 [方法]计算机配合手工检索PUBMED数据库、Cochrane Library、ELSEVIER数据库、中国生物医学文献数据库(CBM)、中国知识资料总库(CNKI)、维普(VIP)、万方数据库等有关的参考文献对比两种手术治疗女性压力性尿失禁并发症发生率，语种限于英语和汉语，，文献检索起止时间均从1996年05至2014年03月，同时检索纳入文献的参考文献，纳入比较TVT-O和TVT-S术治疗SUI的随机对照试验（RCT），并逐个进行质量评价和资料提取。剔除不合本文研究目的或不符合纳入标准的文章。统计学分析采用RevMan5．1软件对纳入研究进行综合定量评价。以患者的治愈率和并发症发生率为中远期疗效观察指标，包括客观治愈率、主观治愈率、术后尿潴留、术后新发尿急症及术后吊带侵蚀/暴露，并计算各个研究的RR值，通过合并RR值比较TVT-O组和TVT-S组中1年客观治愈率、2-3年客观治愈率、2-3年主观治愈率、术后尿潴留、术后新发尿急症及术后吊带侵蚀/暴露的发生率等中远期并发症。 [结果]纳入7项临床随机对照试验包括696例病人，TVT-O共312例，TVT-S（H/U）共384例。Meta分析结果显示，TVT-O组比较TVT-S组：（1）1年客观治愈率有显著性差异（RR=1.20，95%CI(1.12-1.30)，P0.00001）；（2）2-3年客观治愈率有显著性差异（RR=1.19，95%CI(1.09-1.29)，P0.0001）；（3）2-3年主观治愈率有显著性差异(RR=1.12，95%CI(1.03-1.21)，P=0.009)；（4）术后尿潴留发生率无显著性差异(RR=1.74，95%CI(0.64-4.76)，P=0.28)；（5）术后新发尿急症发生率无显著性差异（RR=1.48，95%CI(0.87-2.52)，P=0.15）；（6）术后吊带侵蚀/暴露发生率无显著性差异（RR=0.61，95%CI(0.27-1.35)，P=0.22)。 [结论]TVT-O术式1年、2-3年客观及主观治愈率高于TVT-S术式，术后尿潴留发生率、术后新发尿急症发生率和术后吊带侵蚀/暴露发生率两者无显著性差异。
[Abstract]:[objective] to evaluate the success rate and complications of TVT-O and TVT-S in the treatment of female stress urinary incontinence. [methods] the PUBMED database was searched manually by computer. The Chinese Biomedical Literature Database (CBM), China General knowledge Database (CNKI), Weipu VIPA, Wanfang Database and other related references compared the incidence of complications in the treatment of female stress urinary incontinence in two kinds of operations, the languages of which were limited to English and Chinese. The time of beginning and ending of literature retrieval was from May 1996 to March 2014. The references included in the literature were also retrieved, and the randomized controlled trial of TVT-O and TVT-S for the treatment of SUI were included, and the quality evaluation and data extraction were carried out one by one. Eliminate articles that are not in accordance with the purpose of this study or that do not meet the inclusion criteria. Statistical analysis using RevMan5.1 software to carry out comprehensive quantitative evaluation of the inclusion study. The curative rate and complication rate of the patients were taken as the observation index of the middle and long term curative effect, including objective cure rate, subjective cure rate, postoperative urinary retention, postoperative urinal urgency and postoperative sling erosion / exposure, and the RR values of each study were calculated. The objective cure rate in TVT-O group and TVT-S group was compared by combining RR value. The objective cure rate of 2-3 years was compared. The subjective cure rate, postoperative urinary retention, postoperative acute urethra and the incidence of erosion / exposure of sling were compared. [results] A total of 384 patients were enrolled in 7 randomized controlled trials, including 696 patients with TVT-O and 312 patients with TVT-O. Meta-analysis results showed that there was significant difference in objective cure rate of TTV T O group compared with TVT-S group (n = 11). There was no significant difference in the incidence of urinary retention after operation. There was no significant difference in the incidence of urinary retention after operation (RR1.7495CI0.64-4.76CI0.64-4.76). There was no significant difference in the incidence of new acute urethra after operation (RRU 1.4895CIT 0.87-2.52P0.15A) there was no significant difference in the incidence of sling erosion / exposure after operation. [conclusion] the objective and subjective cure rate of TVT-O was higher than that of TVT-S in 2-3 years. There was no significant difference in the incidence of postoperative urinary retention, the incidence of postoperative urinal urgency and the incidence of sling erosion / exposure.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R713

【参考文献】