疑难病杂志
疑難病雜誌
의난병잡지
JOURNAL OF DIFFICULT AND COMPLICATED CASES
2014年
12期
1268-1271
,共4页
林佳静%曾定元%吴伟英%钟慧敏%卢玉华
林佳靜%曾定元%吳偉英%鐘慧敏%盧玉華
림가정%증정원%오위영%종혜민%로옥화
经闭孔阴道无张力尿道中段悬吊带术%女性压力性尿失禁%远期疗效
經閉孔陰道無張力尿道中段懸弔帶術%女性壓力性尿失禁%遠期療效
경폐공음도무장력뇨도중단현조대술%녀성압력성뇨실금%원기료효
Transobturator tension-free vaginal tape surgery%Stress urinary incontinence%Long term effect
目的:分析经闭孔阴道无张力尿道中段悬吊带术( TVT-O)治疗女性压力性尿失禁( SUI)的远期临床疗效。方法确诊为重度压力性尿失禁的女性患者50例(其中2例为混合性尿失禁)均进行TVT-O治疗,术后随访至少3年,评估TVT-O的远期疗效。随访内容为患者主观症状改善情况、膀胱容量标准化后护垫试验评分,并采用改良的布里斯托问卷( ICIQ-FLUTS)评分判断术后性生活改善情况;安全性指标包括吊带侵蚀和排异情况、手术部位疼痛、泌尿感染等并发症的发生情况。结果随访45例患者,主观总治愈率为75-.6%(34/45),好转率为20.0%(9/45),无效率为4.4%(2/45);客观治愈率为75.6%(34/45),好转率22.2%(10/45),无效率为2.2%(1/45)。45例患者经TVT-O手术治疗后,S评分均较术前明显降低有统计学意义( P <0.05),提示术后性生活质量改善。随访中出现排尿困难1例,出现吊带阴道侵蚀2例,并发症发生率为6.67%。结论 TVT-O在保证较低的远期并发症的同时,实现了较为满意的远期效果,是治疗重度女性压力性尿失禁的理想手术方式。
目的:分析經閉孔陰道無張力尿道中段懸弔帶術( TVT-O)治療女性壓力性尿失禁( SUI)的遠期臨床療效。方法確診為重度壓力性尿失禁的女性患者50例(其中2例為混閤性尿失禁)均進行TVT-O治療,術後隨訪至少3年,評估TVT-O的遠期療效。隨訪內容為患者主觀癥狀改善情況、膀胱容量標準化後護墊試驗評分,併採用改良的佈裏斯託問捲( ICIQ-FLUTS)評分判斷術後性生活改善情況;安全性指標包括弔帶侵蝕和排異情況、手術部位疼痛、泌尿感染等併髮癥的髮生情況。結果隨訪45例患者,主觀總治愈率為75-.6%(34/45),好轉率為20.0%(9/45),無效率為4.4%(2/45);客觀治愈率為75.6%(34/45),好轉率22.2%(10/45),無效率為2.2%(1/45)。45例患者經TVT-O手術治療後,S評分均較術前明顯降低有統計學意義( P <0.05),提示術後性生活質量改善。隨訪中齣現排尿睏難1例,齣現弔帶陰道侵蝕2例,併髮癥髮生率為6.67%。結論 TVT-O在保證較低的遠期併髮癥的同時,實現瞭較為滿意的遠期效果,是治療重度女性壓力性尿失禁的理想手術方式。
목적:분석경폐공음도무장력뇨도중단현조대술( TVT-O)치료녀성압력성뇨실금( SUI)적원기림상료효。방법학진위중도압력성뇨실금적녀성환자50례(기중2례위혼합성뇨실금)균진행TVT-O치료,술후수방지소3년,평고TVT-O적원기료효。수방내용위환자주관증상개선정황、방광용량표준화후호점시험평분,병채용개량적포리사탁문권( ICIQ-FLUTS)평분판단술후성생활개선정황;안전성지표포괄조대침식화배이정황、수술부위동통、비뇨감염등병발증적발생정황。결과수방45례환자,주관총치유솔위75-.6%(34/45),호전솔위20.0%(9/45),무효솔위4.4%(2/45);객관치유솔위75.6%(34/45),호전솔22.2%(10/45),무효솔위2.2%(1/45)。45례환자경TVT-O수술치료후,S평분균교술전명현강저유통계학의의( P <0.05),제시술후성생활질량개선。수방중출현배뇨곤난1례,출현조대음도침식2례,병발증발생솔위6.67%。결론 TVT-O재보증교저적원기병발증적동시,실현료교위만의적원기효과,시치료중도녀성압력성뇨실금적이상수술방식。
Objective To analyze the long term clinical curative effect of transobturator tension-free vaginal tape sur-gery ( TVT-O) in the treatment of female stress urinary incontinence ( SUI). Methods Female patients diagnosed as severe stress urinary incontinence of 50 cases ( including 2 cases of mixed urinary incontinence ) were received TVT-O treatment;Which were followed up for at least 3 years after surgery to evaluate the long-term efficacy of TVT-O.The contents of the follow up including subjective symptoms improvement , the bladder capacity after standardization pad test score , and using modified Bristol questionnaire ( ICIQ /FLUTS) score to judge the situation of improvement of sexual life after surgery;safety indicators include tape erosion and rejection , the operative site pain , urinary tract infection and other complications. Results The fol-low-up was completed in 45 patients, the subjective cure rate was 75.6%(34/45), improvement rate was 20.0%(9/45), no effect in 4.4%(2/45);the objective cure rate was 75.6%(34/45), improvement rate was 22.2%(10/45), no effect in 2.2%(1/45).45 cases of patients after surgical treatment of TVT-O, the S scores were significant decreased with statisti-cal significance ( P <0.05), suggesting that the improvement of the postoperative quality of sexual life. In the follow-up, dysuria was found in 1 case, 2 cases occurred with vaginal tape erosion; the complication rate was 6.67%.Conclusion It demonstrated that the TVT-O could ensure the long term lower incident of complications and reach the long -term satisfied effect;it is an ideal surgical method for the treatment of severe female stress urinary incontinence.