| 李军,张雅,朱海松.改良经闭孔无张力尿道中段悬吊术与腹腔镜下膀胱颈 cooper韧带悬吊术治疗中老年女性压力性尿失禁疗效比较[J].安徽医药,2021,25(1):95-99. |
| 改良经闭孔无张力尿道中段悬吊术与腹腔镜下膀胱颈 cooper韧带悬吊术治疗中老年女性压力性尿失禁疗效比较 |
| Comparison of curative effect between modified tension free vaginal tape?obturator and laparoscopic bladder neck cooper ligament suspension for the treatment of stress urinary incontinence in middle?aged and elderly women |
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| DOI：10.3969/j.issn.1009?6469.2021.01.024. |
| 中文关键词: 尿失禁，压力性 尿道下悬吊术 腹腔镜检查 手术中并发症 手术后并发症 生活质量 妇女 |
| 英文关键词: Urinary incontinence,stress Suburethral slings Laparoscopy Intraoperative complications Postoperative complications Quality of life Woman |
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| 中文摘要: |
| 目的对比改良经闭孔无张力尿道中段悬吊术(TVT?O)与腹腔镜下膀胱颈 cooper韧带悬吊术(Burch)在中老年女性压力性尿失禁(SUI)治疗中的临床价值。方法按照随机数字表法将 2016年 10月至 2018年 9月驻马店市中心医院收治的 116例中老年女性 SUI病人分为 TVT?O组(行改良 TVT?O术)与 Burch组(行腹腔镜下 Burch术)每组 58例。对比两组手术及术后基本情况，随访至术后 6个月，评价对比两组并发症发生率、手术效果、生活质量(I?QOL评分)，变化。结果 TVT?O组手术时间(39.41±7.52)min、术中出血量(121.26±27.63)mL、住院时间(3.67±1.11)d少于 Burch组(56.12±10.43)min、(135.47±30.94)mL、(5.59±1.34)d(P＜0.05)TVT?O组尿管留置时间、手术效果等级分布与 Burch组比较差异无统计学意义(P＞0.05)； TVT?O组术后并发症发生率 3.45%(2，/58)低于 Burch组 15.52%(9/58)(P＜0.05)；术后 6个月 TVT?O组、 Burch组 I?QOL社交尴尬评分［(23.17±1.26)分、(22.86±1.35)分］、行为受限评分［(36.27±3.41)分、(35.84±4.02)分］、心理影响评分［(40.65±4.34)分、(39.54±5.21)分］均较术前［(18.15±3.14)分、(17.69±3.51)分］、［(29.81±4.35)分、(30.24±4.29)分］、［(28.63±5.47)分、(29.42±6.11)分］提高(P＜0.05)且 TVT?O组 I?QOL评分与 Burch组比较差异无统计学意义(P＞0.05)。结论改良 TVT?O术与腹腔镜下 Burch术治疗中老年女性，SUI，均可取得满意手术效果，促进病人术后生活质量改善，但改良 TVT?O术手术时间短、对机体损伤更小，且并发症少，更利于术后早期康复出院。 |
| 英文摘要: |
| Objective To compare the clinical value of modified tension free vaginal tape?obturator(TVT?O)and laparoscopic bladder neck cooper ligament suspension(Burch)in the treatment of stress urinary incontinence(SUI)in middle?aged and elderly women.Methods According to the random number table method，116 middle?aged and elderly female SUI patients admitted toZhumadian Central Hospital from October 2016 to September 2018 were divided into TVT?O group(modified TVT?O surgery)and Burch group(laparoscopic Burch surgery)with 58 cases in each group.The basic conditions of operation and postoperative condi?tions were compared between the two groups.，Patients were followed up to 6 months after operation，and the incidence of complica? tions，surgical effects，and the changes in quality of life(I?QOL score) were evaluated and compared between the two groups. Results The operation time(39.41±7.52)min，intraoperative blood loss(121.26±27.63)mL，hospitalization time(3.67±1.11)d in the TVT?O group were better than those in the Burch group(56.12±10.43)min，(135.47±30.94)mL，(5.59±1.34)d(P＜0.05)，there was no significant difference in catheter retention time compared with Burch group(P＞0.05).There was no significant difference in the grade distribution of surgical effect between the TVT?O group and the Burch group(P＞0.05).The postoperative complication rate of TVT?O group was 3.45%(2/58)which was lower than 15.52%(9/58)of Burch group(P＜0.05).The I?QOL social embarrassment score［(23.17±1.26)points6±1.35)points］，behavior restriction score［(36.27±3.41)points，(35.84± ，(22.8，4.02)points］，psychological impact score［(40.65±4.34)points，(39.54±5.21)points］of the TVT?O group and Burch group at 6 months after surgery were improved compared with the preoperative［(18.15±3.14)points，(17.69±3.51)points］，［(29.81±4.35) points，(30.24±4.29)points］，［(28.63±5.47)points，(29.42±6.11)points］(P＜0.05).And there was no significant difference in I? QOL score between the TVT?O group and the Burch group(P＞0.05).Conclusion Modified TVT?O surgery and laparoscopicBurch surgery for SUI in middle?aged and elderly women can achieve satisfactory surgical results and improve the quality of life ofpatients after surgery.However，the modified TVT?O operation has shorter operation time，less damage to the body，and fewer compli? cations，which is more conducive to early recovery and discharge after surgery. |
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