TVT与TVT―O治疗女性压力性尿失禁疗效评估.docVIP

TVT与TVT―O治疗女性压力性尿失禁疗效评估 　　【摘要】 目的：观察并比较经耻骨后路径阴道无张力尿道中段悬吊术（TVT）及经闭孔路径阴道无张力尿道中段悬吊术（TVT-O）治疗女性压力性尿失禁的临床效果。方法：选择2013年1月-2014年12月在本院收治的女性压力性尿失禁患者60例作为研究对象，其中30例行TVT手术，30例行TVT-O手术。记录比较两种手术路径围手术期各种参数、并发症以及临床治疗效果。结果：TVT组手术时间长于TVT-O组，比较差异有统计学意义（P0.05）；TVT组并发症发生率高于TVT-O组，比较差异有统计学意义（P0.05）。结论：TVT-O手术方式较TVT路径手术时间短，并发症发生率明显降低；两种手术路径均可有效治疗重度压力性尿失禁、但长期疗效有待进一步随访观察。 　　【关键词】 尿失禁； TVT； TVT-O； 治疗结果 　　【Abstract】 Objective：To compare the clinical efficacy of tension-flee vaginal tape（TVT） and transobturator vaginal tape inside out （TVT-O） in the treatment of female stress urinary incontinence（SUI）.Method：60 female patients with SUI in our hospital from January 2013 to December 2014 were selected as the research objects.30 patients were given TVT（TVT group）and the other 30 patients were given TVT-O（TVT-O group）.The perioperative various parameters，the postoperative complications and the treatment effect were recorded and compared between the two groups.Result：The mean operative time of the TVT-O group was shorter than that of the TVT group，the difference was statistically significant（P0.05）.The incidence rate of postoperative complications in the TVT group was higher than that in the TVT-O group，the difference was statistically significant（P0.05）.Conclusion：TVT-O has advantages over TVT in operation time and postoperative complications.TVT and TVT-O have equivalent curative effect on female stress incontinence.Long term follow-ups are necessary to evaluate outcomes of different types of surgery for stress urinary incontinence. 　　【Key words】 Urinary incontinence； TVT； TVT-O； Treatment outcome 　　First-author’s address：The Maternity and Child Health Hospital of Xuzhou City，Xuzhou 221004，China 　　doi：10.3969/j.issn.1674-4985.2015.32.036 　　压力性尿失禁（SUI）是指当膀胱的压力超过了尿道压力，尿液自尿道口渗出，常伴有尿道括约肌功能受损[1]。主要表现为当腹部压力增加如咳嗽、大笑时，不自主的溢尿[2]。关于压力性尿失禁的治疗主要以手术为主。1995年Ulmsten等[3]提出了经耻骨后尿道无张力悬吊术（TVT），因其具有创伤小、手术时间短等优点，迅速得到了各国临床医师的肯定。在不断总结改进的基础上提出了经闭孔路径阴道无张力尿道中段悬吊术（TVT-O）[4]。本文采用回顾性研究方法比较TVT和TVT-O两种手术方式的临床效果，现报