经闭孔无张力尿道吊带术后患者症状和生活质量的变化研究

Study of changes of symptoms and life quality of patients after transvaginal tape-obturator operation

目的探讨分析经闭孔无张力尿道吊带术(TVT-O)后患者症状和生活质量的变化。方法回顾性分析该院2007年2月至2012年4月收治的96例女性压力性尿失禁患者的临床资料,将开展TVT-O前接受经耻骨后无张力尿道吊带术(TVT)的48例患者作为对照组,接受TVT-O的48例患者作为实验组。对比分析两组患者术中的一般情况及术后患者症状与生活质量的变化。结果实验组手术时间、术中出血及住院时间要显著少于对照组(t=17.061,17.026,15.465,P>0.05),两组手术疗效的差异无统计学意义(χ2=0.711,P>0.05);经过手术,两组患者的生活质量评分均较术前有显著提高(29.1±9.6,30.3±9.8vs.70.4±10.2,68.5±11.4,P<0.05),但两组间评分的差异无统计学意义(P>0.05);手术后两组的症状评分及尿垫使用情况均较手术前有明显改善(13.9±2.8,14.1±2.5 vs.5.1±1.2,5.4±1.7,89.6%,93.8%vs.50.0%,58.3%,P<0.05),但两组间的差异无统计学意义(P>0.05)。结论 TVT-O能够显著改善压力性尿失禁患者的生活质量与临床症状,且具有微创、低风险的优势,值得在临床推广,但手术医师仍需具备较多的临床经验。

Objective To study the changes of the symptoms and quality of life in the patients after the transvaginal tape-obtura- tor（TVT-O） operation. Methods To retrospectively analyze the clinical data of 96 female patients with stress urinary incontinence （SUI） in our hospital from February 2007 to April 2012.48 cases of retropubic tension free vaginal tape（TVT） were taken as the control group and 48 cases of TVT-O as the experimental group. The intraoperative general condition and postoperative symptoms changes and life quality were analyzed and compared between the two groups. Results The operation time,blood toss and hospital stay time in the experimental group were significantly less than those in the control group（t= 17. 061,17. 026,15. 465, P〉0.05）, the difference of operative effects between the two groups was not statistically significant（x2= 0. 711, P〉 0.05）. After treatment, all the patients＇ scores of quality of life were significantly improved compared with that before treatment（29.1±9.6,30.3±9.8 vs. 70.4±10.2,68.5 ±11.4, P〈0.05）, but score differences between the two groups showed no statistical significance（P〉0.05 ）, af- ter treatment, the symptom scores and urinal pad use of two groups were obviously improved compared with those before treatment （13.9±2.8,14.1±2.5 vs. 5.1±1.2,5.4±1.7 89.6%,93.8% vs. 50.0G,58.3%,P〈0.05）,but the differences between the two groups were not statistically significant（P〉0.05）. Conclusion TVT-O can improve the symptoms and quality of life in the pa- tients with SUI. In the same time,it has advantages of minimal invasion and low risk,which is worth promoting, but the surgeons need to accumulate more clinical experience.