| 黄振国,曹友汉,许韩峰,蔡晓建,段有军,李天庆,匡小根,阳源.TVT-O治疗女性压力性尿失禁的临床疗效评估.[J].中南医学科学杂志.,2017,(3):280-282, 311. |
| TVT-O治疗女性压力性尿失禁的临床疗效评估 |
| Evaluation of clinical therapeutic effect of TVT-O surgery onfemale stress urinary incontinence |
| 投稿时间：2016-12-12 修订日期：2017-03-13 |
| DOI：10.15972/j.cnki.43-1509/r.2017.03.016 |
| 中文关键词: 压力性尿失禁 女性 经闭孔经阴道无张力尿道中段吊带术 |
| 英文关键词:stress urinary incontinence female tension-free vaginal tape obturator |
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| 中文摘要: |
| 目的 评估经闭孔经阴道无张力尿道中段吊带术(TVT-O)治疗女性压力性尿失禁(SUI)的临床疗效。方法回顾性分析32例TVT-O术治疗中-重度SUI的患者,术前术后均采用国际尿控协会ICS推荐的尿失禁生活质量问卷(I-QOL)进行生活质量评分测定及尿流动力学全套检查；术前术后腹压漏尿点测压(ALPP),最大尿道关闭压(MUCP)进行对比。根据主观症状疗效评价标准评价术后临床疗效。结果手术时间25~35 min,平均31 min,术中出血量均＜35 mL。术后拔除导尿管29例即获得满意控尿。2例出现排尿困难,经尿道扩张留置导尿1周后排尿通畅,1例术后仍存在压力性尿失禁。全组均获随访1~5年,均无尿失禁复发和相关并发症出现,其中1例尿失禁术后效果欠佳随访3年,尿失禁程度未加重。主观症状评估疗效显著,尿动力学检查提示ALPP、MUCP较术前均有显著的控尿满意。结论TVT-O术创伤小,并发症少,恢复快,疗效满意,是一种治疗女性SUI安全有效的方法。 |
| 英文摘要: |
| Objective To evaluate the clinical efficacy of the tension-free vaginal tape obturator (TVT-O) in the treatment of female stress urinary incontinence (SUI).MethodsThe clinical data of 32 cases of moderate-severe degree SUI operated by TVT-O was retrospectively analyzed.All patients were examined by incontinence quality of life recommended by ICS and a complete set of urodynamics both preoperatively and postoperatively.The abdominal leak point pressure (ALPP),maximum urethral closure pressure(MUCP) was compared between the preoperative and postoperative.Clinical therapeutic effect was evaluated by subjective symptom effective evaluation standard.ResultsThe operating time was arranged from 25 to 35 minutes,mean intraoperative blood loss was less than 35 mL,29 cases were able to restrain urinary leakage immediately after removal of catheter postoperatively,2 dysuria cases were cured by indwelling catheter after urethral dilatation for 1 week.Stress urinary incontinence still existed in 1 patient.The entire group were followed up for 1 to 5 years,in which 1 case with postoperative deficient effect was followed up for 3 years and the degree of urinary incontinence was not aggravated while the effect of subject evaluation was significant and the results of both ALPP and MUCP by urodynamics suggested that it was significantly improved in micturition control compared with preoperative,and there were no recurrence of urinary incontinence and related complications.ConclusionsTVT-O is a safe and effective treatment for female SUI with minor trauma,few complications,quick recovery,and reliable satisfactory outcome. |
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