[1]张胜男 郭伟堃 金 芬.经闭孔经阴道尿道中段悬吊带术治疗压力性尿失禁的临床疗效分析[J].大众科技,2020,22(07):62-65.
　Analysis of the Clinical Effect of Transobturator Transvaginal Tape Sling in the Treatment of Stress Urinary Incontinence[J].Popular Science & Technology,2020,22(07):62-65.
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经闭孔经阴道尿道中段悬吊带术治疗压力性 尿失禁的临床疗效分析()
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《大众科技》[ISSN:1008-1151/CN:45-1235/N]

卷:
22
期数:
2020年07
页码:
62-65
栏目:
医药与卫生
出版日期:
2020-07-20

文章信息/Info

Title:
Analysis of the Clinical Effect of Transobturator Transvaginal Tape Sling in the Treatment of Stress Urinary Incontinence
作者:
张胜男 郭伟堃 金 芬
（广西中医药大学附属瑞康医院，广西 南宁 530011）
关键词:
压力性尿失禁; 子宫脱垂; 经闭孔经阴道尿道中段悬吊带术
Keywords:
stress urinary incontinence uterine prolapse transobturator transvaginal tape sling
文献标志码:
A
摘要:
目的：本次研究主要是采用阴道无张力尿道中段悬吊带术（TVT）和经闭孔经阴道尿道中段悬吊带术（TVT-O） 两种术式治疗压力性尿失禁（SUI）患者的临床疗效。方法：共纳入 30 例患尿失禁合并子宫以及阴道脱垂患者，其中 TVT 术式 组患者数有 16 例，TVT-O 术式组患者数有 14 例，并比较二组手术方式的术中、术后以及两者相应并发症等方面。结果：① TVT-O 组：在手术进行的时间、尿管留置的时间以及住院天数上，与 TVT 组进行比较，两者具有统计学意义（P＜0.05）。其中，TVT-O 组在手术时间上较 TVT 组的手术时间短：79.6±4.3 min。②TVT-O 组在术后追踪种出现吊带侵蚀的情况患者有 1 例，发生排尿 困难仅 1 例；TVT 术式组术后出现吊带侵蚀现象 1 例，排尿困难 2 例。③ TVT-O 术式组的患者术后的治愈率较 TVT 高，可达 100%，TVT-O 组患者手术后的治愈率可达 81.25%。结论：TVT-O 术式的手术操作相对较容易、治愈率高，并发症较低且术后 疗效较好，是目前 SUI 手术治疗的发展方向之一。
Abstract:
Objective: To study the clinical efficacy of tension-free vaginal tape (TVT) and transobturator transvaginal tape (TVT-O) in the treatment of stress urinary incontinence (SUI). Methods: a total of 30 patients with urinary incontinence complicated with uterine and vaginal prolapse were included, including 16 patients in TVT group and 14 patients in TVT-O group. The intraoperative, postoperative and corresponding complications of the two groups were compared. Results:① TVT-O group: compared with TVT group in operation time, catheter indwelling time and hospitalization days, the two groups had statistical significance (P＜0.05). The operation time of TVT-O group was shorter than that of TVT group: 79.6 ± 4.3 min. ② In the TVT-O group, there was 1 case ofsling erosion and only 1 case of dysuria. In the TVT group, sling erosion occurred in 1 case and dysuria in 2 cases.③ The postoperative cure rate of TVT-O patients is higher than that of TVT, up to 100%, and the postoperative cure rate of TVT-O patientsis up to 81.25%. Conclusions: TVT-O operation isrelatively easy to operate,with high cure rate, low complications, and good postoperative effect, which is one of the development directions of SUI surgery

参考文献/References:

[1] Maral I, Ozkardes H, Peskircioglu L, et al. Prevalence of stress urinary incontinence in both sexes at or after age 15 years：a cross -sectional study[J]. The Journal of Urology, 2001, 165(2): 408-412. [2] Roger R G. Clinical practice: urinary stress incontinence in women[J]. The New England Journal of Medicine, 2008, 358(10):1029-1036. [3] 中华医学会妇产科学分会妇科盆底学组．女性压力性尿 失禁诊断和治疗指南(2017)[J]. 中华妇产科杂志，2017， 52(5): 289-293. [4] 朱兰，郎景. 女性压力性尿失禁诊断和治疗指南(试行) 的远期疗效和尿动力学分析[J]. 中华妇产科杂志，2011， 46(10): 796-798. [5] Chong E C, Khan A A, Anger J T. The financial burden of stress urinary incontinence among women in the United States[J]. Current Urology Reports, 2011, 12(5): 358-362． [6] Klutke C, Siegel S, Carlin B, et al. Urinary retention after tension free vaginal tapeprocedure: incidence and treatment [J]. Urology, 2001, 58(5): 697- 701. [7] 李卫林，卢子文，李飞平，等. 无张力尿道悬吊改良术 与尿道中段悬吊带术治疗女性压力性尿失禁的临床观察 [J]. 中华医学杂志，2016，96(28): 2238-2240. [8] 朱兰. 与压力性尿失禁手术相关的应用解剖和手术技巧 [J]. 中国实用妇科与产科杂志，2009，25(3): 178-180. [9] 曾海燕. 耻骨后路径阴道无张力尿道中段悬吊术治疗女性压力性尿失禁研究进展[J]. 实用妇产科杂志，2017， 33(7): 498-501. [10] Jun T, Yoon H S, Kim H S, et al. Recurrence rate of stress urinary incontinence in females with initial cure after transobturator tape procedure at 3-year follow-up[J]. Investigative and Clinical Urology, 2017, 58(1): 54-60. [11] Keton K, Oldham L, Brubaker L. Open burch urethropex has a low rate of peri-operative complications[J]. American Journal of Obstetrics and Gynecologyl, 2002, 187(1): 107- 110. [12] 罗德毅，张汉超，戴轶，等. 无张力阴道悬吊系统 TVT-S 治疗女性压力性尿失禁临床分析[J]. 中华泌尿外科杂志， 2011，32(5): 326-329. [13] 杨欣，王建六. 美国妇产科学院盆腔器官脱垂临床实践 指南(2009 年)解读[J]. 中国妇产科临床杂志，2011，12(2): 157-160. [14] 陈玉清，裴慧慧，姚书忠. 经闭孔经阴道无张力尿道中 段悬吊带术治疗女性压力性尿失禁 28 例疗效分析[J]. 实 用妇产科杂志，2014，30(2): 120-123. [15] de Leval J. Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out[J]. European Urology, 2003, 44(6): 724-730. [16] 姚彬，朱艳. 经闭孔无张力尿道中段悬吊术治疗女性压 力性尿失禁[J]. 浙江临床医学，2012，14(6): 704-705. [17] 邹慈，于德新，王毅，等. 经闭孔无张力尿道中段悬吊 改良术式治疗女性压力性尿失禁的中长期疗效分析[J]. 临床泌尿外科杂志，2017，32(8): 614-618. [18] Jeon M J, Chung D J, Park J H, et al. Surgical therapeutic index of tension-free vaginal tape and transobturator tape for stress urinary incontinence[J]. Gynecologic and Obstetric Investigation, 2008, 65(1): 41-46. [19] Alexandridis V, Rudnicki M, Jakobsson U, et al. Adjustable mini-sling compared with conventional mid-urethral slings in women with urinary incontinence: a 3-year follow-up of a randomized controlled trial[J]. International Urogynecology Journal, 2019, 30(2): 1465-1473. [20] Ulmsten U, Henriksson L, Johnson P, et al. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence[J]. International urogynecology journal and pelvic floor dysfunction, 1996, 7(2): 81-86. [22] Rapp D E, Kobashi K C. The evolution of midurethral slings[J]. Nature Clinical Practice Urology, 2008, 5(4): 194-201. [23] Ulmsten U, Johnson P, Rezapour M, et al. A three-year follow up of tension free vaginal tape for surgical treatment of females stress urinary incontinence[J]. British journal of obstetrics and gynaecology, 1999, 106(4): 345-350. [24] 史本康，周尊林，张东青，等. 经阴道无张力悬吊术治 疗女性压力性尿失禁及并发症防治[J]. 中华泌尿外科杂 志，2005，26(11): 772-775. [25] Wein A J. Re: retropublic versus transobturator tension-free vaginal tape(TVT vs TVT-O): five-year results of the Austrian randomized trial[J]. The Journal of Urology, 2019, 201(5): 866-867.

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备注/Memo

备注/Memo:
【收稿日期】2020-05-06 【作者简介】张胜男（1987－），女，黑龙江大庆人，广西中医药大学附属瑞康医院住院医师，医学硕士，研究方向为 妇科肿瘤微创手术与妇科内分泌诊治。 【通信作者】郭伟堃（1976－），男，广西北海人，广西中医药大学附属瑞康医院副主任医师，医学硕士，研究方向为 妇科肿瘤微创手术与妇科内分泌诊治。
更新日期/Last Update: 2020-11-16