不同手术方法联合治疗子宫脱垂合并压力性尿失禁的疗效对比

Comparison on the Effects of Combination Therapy with Different Surgical Methods for the Treatment of Pelvic Organ Prolapse Complicated with Stress Urinary Incontinence

目的研究不同手术方法联合治疗子宫脱垂(POP)合并压力性尿失禁(SUI)的疗效。方法选择2014年1月至2016年1月我院收治的130例子宫脱垂合并压力性尿失禁患者,随机分为两组各65例。对照组患者在阴道盆底重建术的基础上联合无张力尿道中段悬吊术(TVT)进行治疗,观察组患者在阴道盆底重建术的基础上联合聚丙烯网带尿道中段悬吊术(TVTO)进行治疗。比较两组患者的手术疗效和手术情况。结果观察组患者的治愈率(87.69%)和复发率(1.54%)均显著优于对照组(56.92%、10.77%),差异有统计学意义(P<0.05);观察组患者的手术时间、术中出血量、导管留置时间和住院时间均明显少于对照组,差异有统计学意义(P<0.05)。结论阴道盆底重建术联合TVT-O治疗POP合并SUI的疗效更加明显,能有效改善患者术后的生活质量,降低术后并发症发生率。

Objective To study the effects of combination therapy with different surgical methods for the treatment of pelvic organ prolapse （POP） complicated with stress urinary incontinence （SUI）. Methods A total of 130 cases of patients with POP complicated with SUI admitted to our hospital from January 2014 to January 2016 were selected and randomly divided into two groups, with 65 cases in each group. All cases were given pelvic floor reconstruction operation; in addition, the control group was given tension-free vaginal tape （TVT）, and the observation group was given transobturator tension-free vaginal tape （TVT-O）. The clinical effects and surgical indicators of both groups were compared. Results The cure rate of observation group was 87.69%, significantly higher than 56.92% of control group （P〈0.05）, and the recurrence rate of observation group was 1.54%, significantly lower than 10.77% of control group （P〈0.05）. The observation group was superior to the control group in the operation time, intraoperative blood loss, keeping time of catheter and length of hospital stay （P〈0.05）. Conclusions Pelvic floor reconstruction combined with TVT-O has significant efficacy for the treatment of patients with POP complicated with SUI, which can effectively improve patients＇ postoperative quality of life, and reduce the incidence of postoperative complications.