单切口可调节AjustTM吊带治疗固有括约肌障碍型女性压力性尿失禁疗效及安全性分析.docVIP

单切口可调节AjustTM吊带治疗固有括约肌障碍型女性压力性尿失禁疗效及安全性分析 【摘要】目的：评价单切口可调节AjustTM吊带治疗固有括约肌障碍型（ISD）女性压力性尿失禁（SUI）疗效及安全性。方法：回顾性分析我院2013年3月至2014年2月26例接受AjustTM吊带手术的经尿动力学检查证实为尿道固有括约肌障碍型（ISD）SUI患者的临床资料。分别于术后6个月、12个月对患者进行复查、随访。填写经过验证的问卷ICI-Q-SF、PISQ-12、UDI-6/ⅡQ-7，并比较患者手术前后膀胱残尿量（PVR）和最大尿流率（Qmax）评估手术疗效。结果：本组患者术中均无膀胱损伤、尿道损伤、闭孔血管及神经损伤、术后大腿根部疼痛等并发症。术后6个月随访（26例）：治愈率923%，有效率962%；术后12个月随访（11例）：治愈率909%，有效率100%。患者术后末次随访症状及QOL评分均较术前显著改善（P005）。患者术后末次UDI-6及Ⅱ-Q7问卷总体评分较术前有统计学意义降低（P005），术后末次Qmax较术前降低有统计学意义 （P 005）。结论：AjustTM吊带手术是治疗固有括约肌障碍型（ISD）女性压力性尿失禁的微创、安全的手术方法，短期疗效满意，远期疗效有待进一步随访。 【关键词】压力性尿失禁；可调节吊带；固有括约肌障碍；疗效 ；膀胱出口梗阻 Efficacy and safety of AjustTM system for female stress urinary incontinence with ISDSUN Feng， SUN Xincheng， XIE Liang， XU Yanchao， MA Huangbin， SHI Qinglu. Department ofUrology， Cangzhou People’s Hospital， Cangzhou 061000， China 【Abstract】Objectives： To assess the safety and efficacy of AjustTM for surgical treatment of female stress urinary incontinence （SUI） with ISD. Methods： The outcome of 26 AjustTM procedures for female stress urinary incontinence was analyzed. The follow-up time was 6 and 12 months. All the patients were asked to record the ICI-Q-SF ，PISQ-12 and UDI-6/ⅡQ-7 questionnaires before and after operation. The Qmax and PVR before and after operation were collected to evaluate the functions of the patients’ bladder. Results： There were no cases of bladder injury or injury of obturator nerves or vessels in all the patients. 6 months after the operation， the cure rate and effective rate was 92.3% and 96.2% respectively； the final cure rate and effective rate of patients was 909% and 100%. There were notable improvements of common symptom and QOL scores in all the patients （P005）. Conclusion： The AjustTM procedure is a safe， effective and minimally invasive treatment method for female SUI patients with ISD. 【Key words】Stress urinary incontinence； AjustTM； Intrinsic sphincter incontinence； Curative effect； Bladder outlet obstruction 【中图分类号】R167【文献标志码】A 自Delormer等[1]2004年首先采取经闭孔尿