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目的:探讨T-consling吊带治疗女性压力性尿失禁(SUI)的适应证和疗效。方法:回顾性分析采用T-consling吊带治疗13例FSUI患者的临床资料。年龄45~79(58.3±8.9)岁;产次1~5(2.6±1.1)次;体质指数21.0~27.3(24.6±1.8)kg/m2;病程4~27(5.8±3.4)年。膀胱颈抬举试验、咳嗽试验均阳性,均无盆腔手术史以及抗尿失禁手术史,3例阴道前壁轻度脱垂,1例阴道前壁重度脱垂。尿动力学检查均无膀胱出口梗阻,腹压漏尿点压(ALPP)为34~127(65.8±22.6)cmH2O。根据对TVT-S疗效评估方法,对术后效果的评估主要依靠客观和主观评价,观察指标包括手术时间、术后并发症、随访。结果:13例手术时间15~45min,平均25min;术中出血量10~35ml,平均20ml。术后10例症状完全消失,治愈率76.9%。2例手术完全无效,其中1例行二次手术,术后仍无效;1例术后发生排尿困难。随访6~12个月,平均7.8个月,最大尿流率(Qmax)(18.7±5.2)ml/s,尿道阻力因子(URA)(9.3±4.7)cmH2O,与术前比较,差异均无统计学意义(P>0.05)。结论:T-consling吊带治疗女性SUI操作简单,易掌握,对于中轻度SUI患者近期治愈率高,且安全性好。
Objective: To investigate the indications and curative effects of T-consling sling in the treatment of female stress urinary incontinence (SUI). Methods: The clinical data of 13 patients with FSUI treated with T-consling sling were retrospectively analyzed. The age ranged from 45 to 79 years old (58.3 ± 8.9 years). The delivery time ranged from 1 to 5 (2.6 ± 1.1) and the body mass index ranged from 21.0 to 27.3 (24.6 ± 1.8) kg / m2. The course of disease ranged from 4 to 27 (5.8 ± 3.4) years. Bladder neck lift test, cough test were positive, no history of pelvic surgery and incontinence surgery, 3 cases of mild prolapse of the anterior vaginal wall, 1 case of severe prolapse of the anterior vaginal wall. Urodynamic examination showed no bladder outlet obstruction. The abdominal pressure (ALPP) ranged from 34 to 127 (65.8 ± 22.6) cmH2O. According to the evaluation of efficacy of TVT-S, the evaluation of the postoperative outcome mainly depends on objective and subjective evaluation. The observation indexes include operation time, postoperative complications and follow-up. Results: Thirteen patients underwent operation for 15-45 minutes with an average of 25 minutes. The intraoperative blood loss was 10-35 ml with an average of 20 ml. 10 cases of symptoms completely disappeared, the cure rate was 76.9%. Two cases of surgery were completely ineffective, of which 1 case underwent secondary surgery, the procedure was still ineffective; 1 case had dysuria after operation. All patients were followed up for 6 to 12 months with an average of 7.8 months. The maximum Qmax (18.7 ± 5.2) ml / s and urethral resistance factor (URA) (9.3 ± 4.7) cmH2O were not significantly different from those before operation Significance (P> 0.05). Conclusion: T-consling sling for female SUI is simple and easy to grasp. It has high cure rate and good safety for moderate and mild SUI patients.