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目的:探讨经闭孔无张力尿道中段悬吊术(TVT-O)在治疗女性压力性尿失禁(SUI)方面的早期临床效果。方法:回顾性分析北京医院2011年10月~2012年2月行TVT-O治疗50例女性SUI患者的临床资料,观察手术的安全性和早期疗效。结果:50例女性患者客观有效率92%,手术平均时间38.5(25~62)min,术中平均出血量32(20~50)ml。国际尿失禁咨询委员会尿失禁问卷简表(ICI-Q-SF)评分:术前为(16.0±3.1)(14~21)分,术后4周为(8.5±2.4)(4~12)分,差异有统计学意义(P<0.05);1小时尿垫试验:术前平均漏尿(25.7±7.2)(8~50)g,术后4周平均漏尿(5.6±1.4)(1~8)g,差异有统计学意义(P<0.05)。5例出现双侧腹股沟处疼痛,2天~1周后自行缓解。1例术后出现排尿困难,行导尿治疗1周后缓解。术后平均随访1~3个月,症状未再复发。结论:TVT-O是一种操作简便、近期疗效确切、并发症较少的治疗女性SUI的手术方式,便于泌尿外科医生掌握,有广阔的应用前景。
Objective: To investigate the early clinical effect of transthoracic tension-free urethral suspension (TVT-O) in the treatment of female stress urinary incontinence (SUI). Methods: The clinical data of 50 women with SUI who underwent TVT-O in Beijing Hospital from October 2011 to February 2012 were retrospectively analyzed. The safety and early efficacy of the operation were observed. Results: The objective efficiency of the 50 female patients was 92%. The mean operation time was 38.5 (25-62) min. The mean intraoperative blood loss was 32 (20-50) ml. ICI-Q-SF score was (16.0 ± 3.1) (14-21) preoperatively and (8.5 ± 2.4) (4-12) 4 weeks postoperatively , The difference was statistically significant (P <0.05); 1 hour urine pad test: the average preoperative leakage of urine (25.7 ± 7.2) (8 ~ 50) g, 4 weeks after the average leakage of urine (5.6 ± 1.4) 8) g, the difference was statistically significant (P <0.05). Five cases of bilateral inguinal pain, 2 days to 1 week to ease themselves. One patient had dysuria after operation and was relieved after one week of catheterization. After an average follow-up of 1 to 3 months, no recurrence of symptoms. Conclusion: TVT-O is a kind of surgical method for the treatment of female SUI which is easy to operate, with short-term curative effect and less complications. It is easy for urological surgeons to grasp and has broad application prospect.