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目的对比研究无张力阴道吊带术(TVT)和经闭孔无张力阴道吊带术(TVT-O)治疗女性压力性尿失禁(SUI)的临床效果。方法回顾分析2003年3月-2013年4月女性SUI患者61例,其中行TVT 33例,TVT-O28例,术后随访1~62个月,平均22个月。以术后咳嗽、增加腹压无尿液溢出,且B型超声检查无剩余尿为治愈;术后咳嗽、增加腹压少许尿液溢出但较术前改善者为改善;术后咳嗽、增加腹压仍不能控制尿液溢出者为无效。结果两组患者的年龄及病程等临床资料相似,差异均无统计学意义(P>0.05)。61例手术均顺利完成。TVT组手术时间26~45 min,平均(35.5±4.3)min;TVT-O组15~20 min,平均(17.2±3.1)min;两组的手术时间差异有统计学意义(P<0.05)。两组术中出血量差异无统计学意义(P>0.05)。TVT-O组的并发症发生率比TVT组低。两组的治愈率、改善率差异均无统计学意义(P>0.05)。结论 TVT和TVT-O都是治疗SUI安全有效的方法。相比TVT,TVT-O具有无需膀胱镜、手术时间更短、创伤小、并发症发生率更低等优点,是治疗女性SUI更理想的手术方法。
Objective To compare the clinical effects of tension-free vaginal tape (TVT) and trans tension-free vaginal tape (TVT-O) in the treatment of female stress urinary incontinence (SUI). Methods From March 2003 to April 2013, 61 female SUI patients were retrospectively reviewed. Among them, 33 were TVT and 28 were TVT-O. The patients were followed up for 1 to 62 months with an average of 22 months. To postoperative cough, increased abdominal pressure without urine spill, and B-type ultrasound without residual urine cure; postoperative cough, increased abdominal pressure and a little urine overflow but improved compared with preoperative; postoperative cough, increased abdominal Pressure still can not control the urine overflow is ineffective. Results The clinical data of the two groups were similar in age and duration, with no significant difference (P> 0.05). 61 cases of surgery were successfully completed. In TVT group, the operation time was 26-45 min (average, 35.5 ± 4.3) min, TVT-O group was 15-20 min, with an average of (17.2 ± 3.1) min, and the difference was statistically significant (P <0.05). There was no significant difference in bleeding volume between the two groups (P> 0.05). The incidence of complications in the TVT-O group was lower than in the TVT group. There was no significant difference between the two groups in cure rate and improvement rate (P> 0.05). Conclusion Both TVT and TVT-O are safe and effective in the treatment of SUI. Compared with TVT, TVT-O has the advantages of no cystoscopy, shorter operation time, less trauma and lower complication rate, which is a better surgical method for treating female SUI.