改良无张力阴道吊带尿道中段悬吊术治疗女性压力性尿失禁的临床效果评价

目的:评价改良自制聚丙烯网片及弹力钉的无张力尿道中段悬吊术(tension-free viginaI tape,TVT)治疗女性压力性尿失禁(stress udnary incontinence,SUI)的安全性和治疗效果。方法:选择2010年1月～2011年1月确诊为SUI患者60例,分为两组,改良组30例,采用自制聚丙烯网片及弹力钉的无张力尿道中段悬吊术(改良TVT术);对照组30例采用TVT术。对两组术中情况及术后疗效举行定期随访,对比分析。结果:两组患者均在硬膜外麻醉下完成手术。术后7天统计,两组有效率比较差异无统计学意义(χ2=0.1113,P>0.05);在手术时间、出血量、住院时间方面,两组患者比较,差异无统计学意义(P>0.05);治疗费用方面,两组比较差异有统计学意义(P﹤0.01)。手术前后尿失禁次数、尿流率、B超测定残余尿量、国际尿失禁咨询委员会尿失禁问卷表简表(ICI-Q-SF)评分等指标方面,两组比较差异无统计学意义(P>0.05)。全部病例术后无出血、血肿、切口感染及网片排异反应。结论:改良自制聚丙烯网片及弹力钉的TVT术方法简单、操作安全、悬带调节方便,疗效与传统TVT术相当,而且其治疗费用低廉,易为患者接受。

Evaluation of clinical efficacy of modified tension-free vaginal tape in treatment of female stress urinary incontinence

Objective:To evaluate the safety and curative effect of modified tension-free vaginal tape(TVT) in treatment of female stress urinary incontinence(SUI).Methods:Sixty patients who were diagnosed as SUI definitely in the hospital from January 2010 to January 2011 were selected,then they were divided into two groups: 30 patients in modified group were treated with modified TVT,while 30 patients in control group were treated with conventional TVT.The intraoperative situations and postoperative efficacies in the two groups were followed up regularly,then a comparative study was conducted.Results:Surgery was completed under epidural anesthesia in the two groups.There was no significant difference in the effective rate on the seventh day after surgery between the two groups(χ2=0.111 3,P>0.05).There was no significant difference in the operation time,the amount of blood loss,and the hospitalization time between the two groups(P>0.05).There was significant difference in treatment fee between the two groups(P<0.01).In the two groups,there was no significant difference in the frequency of SUI,urinary flow rate,residual urine volume detected by B ultrasonography,and ICI-Q-SF score before and after surgery(P>0.05).No bleeding,hematoma,incision infection,and reject reaction occurred.Conclusion:Modified TVT is simple,safe,and convenient,the curative effect is similar to that of conventional TVT,and the treatment fee is low,so modified TVT is easy to be accepted by the patients.