TVT与TVT—O治疗女性压力性尿失禁疗效评估(1)
【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(P<0.05)，两组术中出血量及住院天数比较，差异无统计学意义(P>0.05)；TVT组并发症发生率高于TVT-O组，比较差异有统计学意义(P<0.05)；两组治愈率、改善率、无效率及总有效率比较，差异均无统计学意义(P>0.05)。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(P<0.05).The differences in perioperative blood loss and hospital stays between the two groups were not statistically significant(P>0.05).The incidence rate of postoperative complications in the TVT group was higher than that in the TVT-O group，the difference was statistically significant(P<0.05).The differences in the cure rate，improvement rate，inefficiency rate and total effective rate between the two groups were not statistically significant(P>0.05).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.
, 百拇医药
【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，现报道如下。
1 资料与方法
1.1 一般资料 选择2013年1月-2014年12月在本院妇科住院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手术治疗(TVT组)，30例行TVT-O治疗(TVT-O组)。纳入标准：(1)压力试验、指压试验阳性；(2)术前彩超检查无残余尿；(3)非妊娠状态；(4)膀胱出口无明显梗阻；(5)无尿失禁手术史、尿路感染、尿瘘、膀胱逼尿肌不稳定；(6)无神经系统疾病。两组一般资料比较差异均无统计学意义(P>0.05)，具有可比性，见表1。, 百拇医药(薛华 姜智慧 周健 王海燕 李娟)
【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(P<0.05).The differences in perioperative blood loss and hospital stays between the two groups were not statistically significant(P>0.05).The incidence rate of postoperative complications in the TVT group was higher than that in the TVT-O group，the difference was statistically significant(P<0.05).The differences in the cure rate，improvement rate，inefficiency rate and total effective rate between the two groups were not statistically significant(P>0.05).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.
, 百拇医药
【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，现报道如下。
1 资料与方法
1.1 一般资料 选择2013年1月-2014年12月在本院妇科住院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手术治疗(TVT组)，30例行TVT-O治疗(TVT-O组)。纳入标准：(1)压力试验、指压试验阳性；(2)术前彩超检查无残余尿；(3)非妊娠状态；(4)膀胱出口无明显梗阻；(5)无尿失禁手术史、尿路感染、尿瘘、膀胱逼尿肌不稳定；(6)无神经系统疾病。两组一般资料比较差异均无统计学意义(P>0.05)，具有可比性，见表1。, 百拇医药(薛华 姜智慧 周健 王海燕 李娟)