CAJ | 학술논문

目的探讨经闭孔阴道无张力尿道中段悬吊术(tension-free vaginal tape-obturator,TVT-O)治疗女性压力性尿失禁(stress urinary incontinence,SUI)的临床疗效、术后并发症及其对手术安全性及生活质量的影响.方法对130例女性SUI患者行TVT-O治疗.对患者围手术期情况、术后并发症、手术前后生活质量的随访情况进行对比分析.结果 130例患者全部顺利完成手术,手术时间(47.01±18.82) min,术中出血量(64.38±99.62) ml,留置导尿(2.67 ±0.90)d,住院时间(4.73±2.14)d.术后完成随访101例,随访率为77.7％,其术后ⅡQ-7评分[(1.59±4.37)分]显著低于术前[(15.74±3.87)分,Z=-8.601,P＜0.01],术后UDI-6评分[(1.63±2.66)分]显著低于术前[(10.51±3.70)分,Z=-8.549,P＜0.01].患者术后尿失禁主观完全治愈73例(72.3％),主观改善明显11例(10.9％),术后无效6例(5.9％)；尿垫使用13例(12.9％)；术后出现网片暴露侵蚀2例(2.0％)；术后性生活有不适感8例(7.9％).结论 TVT-O治疗女性SUI,操作简便、并发症少、安全性高,术后复发率低,患者生活质量明显提高,对盆底功能重建治疗具有积极意义.网片并发症不可忽视,需要进一步探讨.
목적 탐토경폐공음도무장력뇨도중단현조술(tension-free vaginal tape-obturator,TVT-O)치료녀성압력성뇨실금(stress urinary incontinence,SUI)적림상료효、술후병발증급기대수술안전성급생활질량적영향.방법 대130례녀성SUI환자행TVT-O치료.대환자위수술기정황、술후병발증、수술전후생활질량적수방정황진행대비분석.결과 130례환자전부순리완성수술,수술시간(47.01±18.82) min,술중출혈량(64.38±99.62) ml,류치도뇨(2.67 ±0.90)d,주원시간(4.73±2.14)d.술후완성수방101례,수방솔위77.7％,기술후ⅡQ-7평분[(1.59±4.37)분]현저저우술전[(15.74±3.87)분,Z=-8.601,P＜0.01],술후UDI-6평분[(1.63±2.66)분]현저저우술전[(10.51±3.70)분,Z=-8.549,P＜0.01].환자술후뇨실금주관완전치유73례(72.3％),주관개선명현11례(10.9％),술후무효6례(5.9％)；뇨점사용13례(12.9％)；술후출현망편폭로침식2례(2.0％)；술후성생활유불괄감8례(7.9％).결론 TVT-O치료녀성SUI,조작간편、병발증소、안전성고,술후복발솔저,환자생활질량명현제고,대분저공능중건치료구유적겁의의.망편병발증불가홀시,수요진일보탐토.
Objective To observe the clinical short-and long-term curative effect of the surgical treatment of female stress urinary incontinence (SUI) with tension-free vaginal tape-obturator (TVT-O) treatment,and discuss the safety of the operation and postoperative quality of life.Methods The data were collected from 130 patients with SUI who were underwent TVT-O treatment.The patients'perioperative period,follow-up of postoperative complications,and comparison of the quality of life before and after surgery were analyzed retrospectively.Results A total of 130 patients was successfully completed their surgeries with a mean operative time (47.01 ± 18.82)min,average blood loss (64.38 ±99.62)ml,mean catheterization (2.67 ±0.90)d,and the average length of stay (4.73 ±2.14)d.A total of 101 cases was completed the postoperative follow-up with (a) preoperative quality of life in patients with ⅡQ-7 score 6 to 21 points and an average of (15.74 ± 3.87) min,(b) symptoms of lower urinary tract UDI-6 score of 3 to 22 minutes and the average (10.51 ± 3.70) min,(c) postoperative quality of life improved significantly ⅡQ-7 score from 0 to 21 points and an average of (1.59 ±4.37)points,and (e) UDI-6 score 0 to 14 points and an average of (1.63 ± 2.66)points.A total of 73 patients (72.3％) had the postoperative urinary incontinence,which subjective symptom were completely cured,significant improvement was 11 cases (10.9％),ineffectiveness was 6 cases (5.9％),pad using was 13 patients (12.9％),vaginal mesh exposure and erosion was 2 patients(2.0％),the sexual life postoperatively was affected in 8 patients (7.9％).Conclusions TVT-O treatment of SUI is not only easy to operate but also has clinically high security,few complications,low recurrence rate,and significantly improved patients' living quantities.However,patch compli cations can not be ignored and need further discussion.