中-重度压力性尿失禁仿生物理治疗与TVT-O手术疗效的对比研究

目的探讨仿生物理治疗及无张力经闭孔阴道吊带术(tension-free vaginal tape obturator technique,TVT-O)治疗压力性尿失禁的疗效,并行对比分析。方法选取确诊为中-重度压力性尿失禁的患者108例为研究对象,根据患者意愿分为非手术组及手术组,非手术组54例,应用Phenix USB4盆底功能治疗仪进行系统仿生物理治疗3疗程,行疗效分析;手术组54例,实施TVT-O术,行疗效分析。结果非手术组1个疗程仿生物理治疗后评估,44例有效,有效率81.48%,入组成员继续坚持2疗程仿生物理治疗,疗程结束后1年复查,52例有效,其中46例治愈,1年有效率96.30%,治愈率85.19%;手术组术后即时评估,50例有效,有效率92.59%,术后1年复查,49例有效,其中47例治愈,术后1年有效率90.74%,治愈率87.04%。非手术组治疗1疗程有效率显著低于TVT-O术后即时疗效,差异有统计学意义,P0.05;但两组治疗后1年有效率及治愈率比较,差异均无统计学意义(P0.05),且手术组患者出现了围手术期相关并发症及远期并发症。结论 SUI的仿生物理治疗是一项有效的保守治疗方法,能有效缓解症状甚至治愈,预防病情进一步加重,对于中-重度压力性尿失禁患者而言,其远期治疗效果与手术治疗效果相当,但能有效避免手术并发症,值得在临床广泛推广。

The Comparative Study of the Curative Effect in Bionics-physics Treatment and TVT-O Procedure on the Mid-severe Stress Urinary Incontinence

Objective To investigate the curative effect of bionics-physics treatment and tension-free va- ginal tape obturator technique （TVT-O） on the mid-severe stress urinary incontinence （SUI）. Methods One hundred and eight women with mid- severe SUI were grouped on the basis of will, non operation group （ n = 54） received bionics-physics cure by using Phenix USB4 for total three courses of treatment, and the operation group （n = 54） received TVT-O procedure. The curative effects were analyzed. Results For one course of treat- ment, 44 samples of non operation group got good response with the effective rate of 81.48%. One year after 3 courses of treatment, 52 samples of the non operation group got good response, 46 samples got cured with the one-year effective rate of 96.30% and cure rate of 85.19%. 50 samples of operation group got good response after TVT-O procedure with the effective rate of 92.59%. One year after operation, 49 samples got good results and 47 samples got cured. The effective rate was 90.74% and thi~ cure rate was 87.04%. The one course ef- fective rate in non operation group was lower than the postoperative effective rate in operation group, P 〈 0.05 ; But neither the effective rate nor the cure rate showed significant difference in non operation group and operation group one year after the end of treatment course （P 〉 0.05 ）. Furthermore, the operation group showed some complications during perioperative time and long term complications after operation. Conclusion It is an effective expctant treatment and could relieve the symptoms and heal well of the bionics-physics treatment for the mid-severe SUI. It also shows the similar therapeutic efficacy as TVT-O procedure which has the operative and postoperative complications. It could be applied generally in clinic.