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目的探讨尿动力学检查在压力性尿失禁诊疗中的应用价值。方法女性压力性尿失禁患者100例,经闭孔尿道中段无张力悬吊术(TVT-O)治疗。所有患者术前和术后6个月均行尿动力学检查,并填写国际尿失禁咨询委员会问卷简表(ICIQ-SF),统计主观治愈率,分析尿动力学主要参数的变化。结果术后6个月的主观治愈率为87.0%,改善率为10.0%,失败率为3.0%。ICIQ-SF评分显示,与术前比较,术后尿失禁症状改善[(18.5±3.4)分vs.(3.8±1.8)分](P<0.05)。术前最大尿流率和膀胱出口梗阻指数分别为(29.6±8.2)ml/s和-20.4±14.7,术后改善为(20.4±5.7)ml/s和-33.6±20.6(P<0.05)。而术后其他尿动力学指标无明显改变(P>0.05)。结论尿动力检查是判断尿失禁类型和评估TVT-O手术近期疗效的有效手段。
Objective To investigate the value of urodynamic examination in the diagnosis and treatment of stress urinary incontinence. Methods 100 cases of female stress urinary incontinence were treated by TVT-O in the middle of the closed-cell urethra. All patients underwent urodynamic examination preoperatively and 6 months after operation. ICIQ-SF was filled in and the subjective cure rate was calculated. The main parameters of urodynamics were analyzed. Results The subjective cure rate at 6 months after operation was 87.0%, the improvement rate was 10.0% and the failure rate was 3.0%. The ICIQ-SF score showed an improvement in postoperative urinary incontinence compared with preoperative [(18.5 ± 3.4) vs. (3.8 ± 1.8) points] (P <0.05). The maximum preoperative urinary flow rate and bladder outlet obstruction index were (29.6 ± 8.2) ml / s and -20.4 ± 14.7, respectively. The postoperative improvement was (20.4 ± 5.7) ml / s and -33.6 ± 20.6 (P <0.05), respectively. No significant changes in other urodynamic parameters (P> 0.05). Conclusion Urodynamic examination is an effective measure to judge the type of urinary incontinence and assess the short-term efficacy of TVT-O surgery.