两种术式治疗女性压力性尿失禁效果和安全性的随机对照研究

发布时间：2018-09-08 21:10

【摘要】：目的通过与改良的经闭孔阴道无张力尿道中段悬吊术(modified tension-free vaginal tape-obturator,TVT-Abbrevo)对比,研究可调节单切口微小吊带(adjustable single-incision sling,TVTAjust)治疗女性压力性尿失禁的疗效和安全性。方法筛选2015年3月至2016年7月在我院泌尿外科明确诊断为压力性尿失禁的女性患者60例,年龄(50.5±7.6)岁,体质量指数(24.9±3.3),按随机数字表法分为TVT-Abbrevo组和TVT-Ajust组(n=30)。术前评估患者年龄、体质量指数、分娩次数、最大尿流率、腹压漏尿点压等一般情况;对比分析手术时间、术中出血量、是否合并有并发症、术后疼痛、主客观治愈率、生活质量等指标。结果 TVT-Ajust组术中出血量显著少于TVT-Abbrevo组(P0.05);术后排尿困难有4例,每组各有2例,其中TVT-Ajust组合并有1例阴道吊带腐蚀;TVT-Ajust组术后4周疼痛程度显著小于TVT-Abbrevo组(P0.05);TVT-Abbrevo组与TVT-Ajust组术后主观治愈率和客观治愈率差异无统计学意义(P0.05);2组术后患者生活质量较前均有明显提升(P0.05);2种手术方式均不能显著改善急迫性尿失禁症状。结论 TVT-Ajust治疗女性压力性尿失禁是安全、有效的,与TVT-Abbrevo相比,术中出血量小、术后疼痛程度及术后中重度疼痛发生率明显减小、术后恢复快,但长期疗效需进一步观察。
[Abstract]:Objective to study the efficacy and safety of adjustable single incision microsling (adjustable single-incision sling,TVTAjust) in the treatment of female stress urinary incontinence by comparing with the modified vaginal tension free mid-urethral suspension (modified tension-free vaginal tape-obturator,TVT-Abbrevo). Methods 60 female patients with stress urinary incontinence, aged (50.5 卤7.6) years and body mass index (24.9 卤3.3), were selected from March 2015 to July 2016. They were randomly divided into TVT-Abbrevo group and TVT-Ajust group (n = 30). The patients' age, body mass index, times of delivery, maximum urinary flow rate, abdominal pressure leakage point pressure were evaluated before operation, operation time, intraoperative bleeding volume, complications, postoperative pain, subjective and objective cure rate were compared and analyzed. Quality of life and other indicators Results the amount of intraoperative bleeding in TVT-Ajust group was significantly lower than that in TVT-Abbrevo group (P0.05), and there were 4 cases of dysuria after operation, 2 cases in each group. There was no significant difference in postoperative subjective and objective cure rate between TVT-Ajust group and TVT-Ajust group (P0.05) compared with TVT-Abbrevo group (P0.05). (P0.05) the quality of life of postoperative patients in TVT-Ajust group was significantly lower than that in TVT-Abbrevo group (P0.05), and there was no significant difference in subjective and objective cure rate between TVT-Abbrevo group and TVT-Ajust group (P0.05). There was significant improvement (P0.05). Neither of the two surgical methods could significantly improve the symptoms of urgent urinary incontinence. Conclusion TVT-Ajust is safe and effective in the treatment of female stress urinary incontinence. Compared with TVT-Abbrevo, the amount of intraoperative bleeding is smaller, the incidence of postoperative pain and moderate and severe postoperative pain is significantly reduced, and the postoperative recovery is fast. However, the long-term curative effect needs further observation.
【作者单位】：第三军医大学西南医院全军泌尿外科研究所;
【基金】：第三军医大学西南医院院管课题(SWH2015LC14)~~
【分类号】：R699.7

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