单切口可调节Ajust吊带治疗女性压力性尿失禁术后性功能和生活质量的短期疗效评价

发布时间：2017-12-28 18:16

本文关键词：单切口可调节Ajust吊带治疗女性压力性尿失禁术后性功能和生活质量的短期疗效评价　出处：《中国微创外科杂志》2016年04期 　论文类型：期刊论文

【摘要】：目的探讨单切口可调节Ajust吊带治疗女性压力性尿失禁(stress urinary incontinence,SUI)术后性功能和生活质量。方法 2013年1月~2014年6月36例SUI行单切口可调节Ajust尿道中段无张力悬吊术,术前、术后6个月采用咳嗽压力实验、1h尿垫试验、尿失禁生活质量问卷(incontinence quality of life,I-QOL)、患者改善整体印象的问卷(patient global impression of improvement,PGI-I)进行手术效果和生活质量评价,通过女性性功能指数(female sexual function index,FSFI)对患者进行术前和术后性功能评价。结果 36例手术均获得成功,均完成6个月随访,客观和主观治愈率97.2%(35/36),I-QOL评分显著提高[术前(56.21±7.24)分,术后6个月(89.35±5.37)分,t=-26.143,P=0.000]。FSFI总分术后比术前明显改善[术前(23.76±5.21)分,术后(27.37±5.14)分,t=-3.624,P=0.000]。FSFI的6项指标中,有4项分数明显提高,包括性欲[术前(3.21±0.63)分,术后6个月(3.97±0.92)分,t=-3.078,P=0.004]、性唤起[术前(3.75±1.08)分,术后6个月(4.41±0.92)分,t=-2.683,P=0.012]、性高潮[术前(3.93±1.23)分,术后6个月(4.56±0.85)分,t=-2.952,P=0.008]、性满意度[术前(4.37±1.09)分,术后6个月(5.32±0.79)分,t=-2.417,P=0.022]。非性功能障碍的SUI患者比例由术前41.7%(15/36)增加至术后66.7%(24/36),但无统计学差异(Mc Nemar检验,P=0.766)。结论单切口可调节Ajust尿道中段无张力悬吊术能够改善Ⅰ、Ⅱ级SUI患者的症状和性功能,近期疗效良好,对于Ⅲ级SUI患者疗效尚不确定。
[Abstract]:Objective to investigate the sexual function and quality of life in the treatment of female stress urinary incontinence (stress urinary incontinence (SUI)) with single - incision adjustable Ajust sling. January 2013 ~2014 year in June 36 cases of SUI underwent single incision Ajust adjustable tension - free mid urethral suspension surgery, preoperative and postoperative 6 months with cough incontinence quality of life pressure test, 1H and urine pad test questionnaire (incontinence quality of life, I-QOL), with improved overall impression questionnaire (patient global impression of improvement, PGI-I) of the surgical effect and evaluation of the quality of life, the female sexual function index (female sexual function index, FSFI) to evaluate the sexual function of patients with preoperative and postoperative. Results all 36 operations were successful, all completed 6 months follow-up. The objective and subjective cure rate was 97.2% (35/36), and the I-QOL score improved significantly [before operation (56.21 + 7.24), 6 months after operation (89.35 + 5.37), t=-26.143, P=0.000]. The total score of FSFI was significantly better than preoperative (23.76 + 5.21), after operation (27.37 + 5.14), t=-3.624, P=0.000]. The 6 indexes of FSFI, there are 4 scores improved significantly, including sexual desire [preoperative (3.21 + 0.63), 6 months after operation (3.97 + 0.92), t=-3.078, P=0.004], preoperative sexual arousal [(3.75 + 1.08), 6 months after operation (4.41 + 0.92), t=-2.683, P=0.012], orgasm [preoperative (3.93 + 1.23), 6 months after operation (4.56 + 0.85), t=-2.952, P=0.008], the degree of satisfaction of preoperative [(4.37 + 1.09), 6 months after operation (5.32 + 0.79), t=-2.417, P=0.022]. The proportion of SUI patients with non sexual dysfunction increased from 41.7% (15/36) before operation to 66.7% (24/36) after operation, but there was no statistical difference (Mc Nemar test, P=0.766). Conclusion single incision adjustable Ajust urethral midline tension free suspension can improve symptoms and sexual functions of patients with grade I and SUI. The short-term effect is good, and the efficacy for patients with grade III SUI is uncertain.
【作者单位】：郑州大学第二附属医院妇产科;
【分类号】：R699.7
【正文快照】： 在全世界范围内,约有25%的女性受到尿失禁的困扰,严重影响女性的生活质量和性功能[1]。对组织侵入性很小的尿道中段悬吊带改变了压力性尿失禁(stress urinary incontinence,SUI)的外科手术治疗模式。单切口悬吊带(single-incision slings,SIS)作为尿道中段吊带的第3代产品代表

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