两种术式治疗女性压力性尿失禁效果和安全性的随机对照研究

付坚; 沈文浩

doi:10.16016/j.1000-5404.201709004

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两种术式治疗女性压力性尿失禁效果和安全性的随机对照研究

临床医学 | 更新时间：2026-01-09

- 两种术式治疗女性压力性尿失禁效果和安全性的随机对照研究
- Curative efficacy and safety of 2 surgical approaches in management of female stress urinary incontinence: a prospective randomized controlled trial
- 第三军医大学学报 2017年39卷第24期页码：2418-2422
- 作者机构：
  
  400038 重庆，第三军医大学西南医院全军泌尿外科研究所
- 作者简介：
  
  [沈文浩，E-mail：chongqingswh@aliyun.comSHEN Wenhao, E-mail:chongqingswh@aliyun.com
- 基金信息：
  
  第三军医大学西南医院院管课题(SWH2015LC14)
- DOI：10.16016/j.1000-5404.201709004
  中图分类号： R181.23;R694.54;R699.5
- 收稿：2017-09-01，
  
  修回：2017-09-27，
  
  纸质出版：2017-12-30
- 稿件说明：
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付坚, 沈文浩. 两种术式治疗女性压力性尿失禁效果和安全性的随机对照研究[J]. 第三军医大学学报, 2017,39(24):2418-2422.

Jian FU, Wenhao SHEN. Curative efficacy and safety of 2 surgical approaches in management of female stress urinary incontinence: a prospective randomized controlled trial[J]. Journal of Third Military Medical University, 2017, 39(24): 2418-2422.
付坚, 沈文浩. 两种术式治疗女性压力性尿失禁效果和安全性的随机对照研究[J]. 第三军医大学学报, 2017,39(24):2418-2422. DOI： 10.16016/j.1000-5404.201709004.

Jian FU, Wenhao SHEN. Curative efficacy and safety of 2 surgical approaches in management of female stress urinary incontinence: a prospective randomized controlled trial[J]. Journal of Third Military Medical University, 2017, 39(24): 2418-2422. DOI： 10.16016/j.1000-5404.201709004.

摘要

目的

通过与改良的经闭孔阴道无张力尿道中段悬吊术(modified tension-free vaginal tape-obturator，TVT-Abbrevo)对比，研究可调节单切口微小吊带(adjustable single-incision sling，TVT-Ajust)治疗女性压力性尿失禁的疗效和安全性。

方法

筛选2015年3月至2016年7月在我院泌尿外科明确诊断为压力性尿失禁的女性患者60例，年龄(50.5±7.6)岁，体质量指数(24.9±3.3)，按随机数字表法分为TVT-Abbrevo组和TVT-Ajust组(

=30)。术前评估患者年龄、体质量指数、分娩次数、最大尿流率、腹压漏尿点压等一般情况；对比分析手术时间、术中出血量、是否合并有并发症、术后疼痛、主客观治愈率、生活质量等指标。

结果

TVT-Ajust组术中出血量显著少于TVT-Abbrevo组(

＜0.05)；术后排尿困难有4例，每组各有2例，其中TVT-Ajust组合并有1例阴道吊带腐蚀；TVT-Ajust组术后4周疼痛程度显著小于TVT-Abbrevo组(

＜0.05)；TVT-Abbrevo组与TVT-Ajust组术后主观治愈率和客观治愈率差异无统计学意义(

0.05)；2组术后患者生活质量较前均有明显提升(

＜0.05)；2种手术方式均不能显著改善急迫性尿失禁症状。

结论

TVT-Ajust治疗女性压力性尿失禁是安全、有效的，与TVT-Abbrevo相比，术中出血量小、术后疼痛程度及术后中重度疼痛发生率明显减小、术后恢复快，但长期疗效需进一步观察。

Abstract

Objective

To compare the effectiveness and complications of adjustable single-incision sling (TVT-Ajust) and modified tension-free vaginal tape-obturator (TVT-Abbrevo)for the treatment of female stress urinary incontinence(SUI).

Methods

A total of 60 female patients with SUI admitted in our institute from March 2015 to July 2016 were enrolled in this study

and then randomly assigned into TVT-Abbrevo and TVT-Ajust groups (

=30 for each group).The patients were at an average age of 50.5±7.6 years and had a mean body mass index(BMI) of 24.9±3.3. Their age

BMI

parity

maximum flow rate

and abdominal leak point pressure (ALPP) were evaluated before operation. Operation time

intraoperative bleeding volume

operation-related complications

postoperative pain

objective and subjective cure rates

and quality of life were compared between the 2 groups.

Results

The intraoperative bleeding volume was significantly less in the TVT-Ajust group than the TVT-Abbrevo (

0.05). There were 4 cases of postoperative dysuria

with each group having 2 cases

and vaginal sling corrosion was found in 1 case from the TVT-Ajust group. The patients of TVT-Ajust

group experienced obviously milder postoperative pain than those of the TVT-Abbrevo group at 4 weeks after surgery(

0.05). There were no notable differences in objective and subjective cure rates between the 2 groups(

0.05). The quality of life was obviously improved in all the 60 patients after surgery (

0.05). However

both surgical approaches could not significantly improve the symptoms of urge incontinence.

Conclusion

TVT-Ajust procedure is safe and effective in treatment of female SUI. Compared with TVT-Abbrevo

it has less amount of intraoperative bleeding

milder postoperative pain

reduced incidence of postoperative moderate to severe pain

and faster postoperative recovery. But long-term outcomes need to be further observed.

关键词

Keywords

references

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