局麻下经阴道无张力尿道中段悬吊术治疗女性压力性尿失禁28例

目的探讨局麻下经阴道无张力尿道中段悬吊术（tension-free vaginal tape,TVT）治疗女性压力性尿失禁（stressurinary incontinence,SUI）的临床效果。方法选取我院2007年3月~2010年5月进行TVT术治疗的69例女性SUI患者作为研究对象,根据麻醉方法不同分为两组：局麻组28例和硬膜外组41例。比较两组临床疗效及手术时间、留置尿管时间、术中出血量、术后并发症发生率。结果局麻组手术治愈27例（96.4%）,与硬膜外组37例（90.2%）相比差异无统计学意义（P〉0.05）;而局麻组手术时间（28.6±3.2）min]、留置尿管时间（2.1±0.5）d]、住院时间（5.9±1.1）d]、术中出血量（29.0±2.5）mL]、术后尿潴留发生率（0）等方面均显著少于硬膜外组（60.2±6.5）min,（5.6±1.2）d,（8.6±1.3）d,（105.3±21.9）mL,9.8%],差异有统计学意义（P〈0.05）。结论 TVT术是治疗女性SUI的一种安全、有效的手术方式,而采用局麻方式手术时间和住院时间短、出血少、术后尿潴留少。

28 cases of female stress urinary incontinence by tension free vaginal tape under local anesthesia

Objective To assess the efficacy of tension free vaginal tape(TVT) under local anesthesia procedure in treatment of female stress urinary incontinence tress urinary incontinence(SUI).Methods In our hospital from March 2007 to May 2010 for TVT treatment of 69 cases of female SUI patients were selected as research subjects,according to anesthesia were divided into two groups: 28 cases local anesthesia group and 41 cases epidural group.Therapeutic effect,operation time,indwelling catheter time,blood loss and postoperative complication rate were compared.Results The surgery cured of anesthesia group(96.4%) and epidural group(90.2%) were compared with no significant difference(P > 0.05);The local anesthesia operative time (28.6 ± 3.2)min],indwelling catheter time (2.1± 0.5)d],length of hospital stay (5.9 ± 1.1)d],blood loss (29.0 ± 2.5)mL],the incidence of postoperative urinary retention(0),were significantly less than the epidural group(60.2±6.5)min,(5.6±1.2)d,(8.6±1.3)d,(105.3±21.9)mL,9.8%)],the difference was significant(P < 0.05).Conclusion TVT is a safe and effective surgical method for the treatment of female SUI,and by way of surgical anesthesia,time and hospital stay is shorter,bleeding and postoperative urinary retention is less.