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目的:通过与经闭孔无张力尿道中段吊带术(TOT)的比较,评估单切口Needleless无针吊带治疗女性压力性尿失禁的疗效和安全性。方法:将2014年9月~2015年9月期间收治的压力性尿失禁患者采用信封抽取方式随机分为Needleless组和TOT组,比较两组手术时间、术中出血量、住院时间、手术治愈率、手术并发症、术后疼痛等围手术期指标及随访后手术治愈率、压力性尿失禁评分、腹股沟/大腿内侧疼痛等指标。结果:共计164例患者入组本研究,Needleless组78例,TOT组86例,两组患者术前一般资料差异无统计学意义。围手术期比较,Needleless组在手术时间、术中出血量、术后24h疼痛及住院时间方面均明显优于TOT组,差异有统计学意义(P<0.01)。术后2周手术治愈率及围手术期并发症两组间差异无统计学意义(P>0.05),Needleless组在腹股沟/大腿内侧疼痛评分方面优于TOT组(P<0.01);术后6、12个月手术治愈率、尿垫试验及ICIQ-SF评分两组差异均无统计学意义(P>0.05),腹股沟疼痛发生率Needleless组低于TOT组,但差异无统计学意义(P>0.05)。两组患者术后生活质量评分较术前均有显著提高(P<0.01),但两组间比较差异无统计学意义(P>0.05)。结论:单切口Needleless无针吊带治疗女性压力性尿失禁疗效与TOT手术相当,手术简便快捷,术中出血少,恢复快,可明显降低患者术后腹股沟区疼痛,缩短住院时间,是一种简便、安全、有效的微创吊带手术。
OBJECTIVE: To evaluate the efficacy and safety of single-incision Needleless needleless sling for the treatment of female stress urinary incontinence by comparing with transthoracic tension-free mid-urethral sling (TOT). Methods: Patients with stress urinary incontinence who were treated between September 2014 and September 2015 were randomly divided into Needleless group and TOT group by envelope extraction. The operative time, intraoperative blood loss, hospitalization time, operative cure rate , Surgical complications, postoperative pain and other perioperative indicators and follow-up of surgical cure rate, stress incontinence score, inguinal / thigh medial pain and other indicators. Results: A total of 164 patients were enrolled in this study. There were 78 cases in Needleless group and 86 cases in TOT group. There was no significant difference in preoperative general data between the two groups. Perioperative period, Needleless group was significantly better than TOT group in operation time, intraoperative blood loss, 24h postoperative pain and hospital stay, the difference was statistically significant (P <0.01). There were no significant differences in the surgical cure rate and perioperative complications between the two groups at 2 weeks postoperatively (P> 0.05). Needleless group was superior to TOT group in groin / inner thigh pain score (P <0.01) (P> 0.05). The incidence of groin pain in Needleless group was lower than that in TOT group, but the difference was not statistically significant (P> 0.05). There was no significant difference in the cure rate, urine pad test and ICIQ- 0.05). The postoperative quality of life scores of both groups were significantly higher than those before operation (P <0.01), but there was no significant difference between the two groups (P> 0.05). Conclusion: Needleless needle-free sling for treating female stress urinary incontinence has the same curative effect as TOT operation. The operation is simple and quick, less bleeding during operation and rapid recovery. It can reduce the postoperative groin pain and shorten the hospital stay, which is a simple and convenient , Safe and effective minimally invasive surgery.