经闭孔途径3种不同类型吊带治疗女性压力性尿失禁疗效比较

Curative effects of three types of trans-obturator tension-free vaginal tape therapy for female patients with stress incontinence

目的:回顾性研究经闭孔途径3种不同类型吊带(TVT-O、Adjust、Tiloop)治疗女性压力性尿失禁的疗效。方法:回顾性分析首都医科大学密云教学医院2008年1月至2017年9月期间收治的女性压力性尿失禁78例患者,其中TVT-O组32例,Adjust组26例,Tiloop组20例,比较三组手术时间、术中出血量、住院时间、手术治愈率、手术并发症、术后疼痛等围手术期指标及随访术后压力性尿失禁评分、腹股沟/大腿内侧疼痛等指标。结果:三组患者术前一般资料差异无统计学意义;围手术期比较,三组在手术时间、术中出血量及住院时间方面差异无统计学意义(P>0.05);术后并发症三组间差异无统计学意义(P>0.05),Adjust组在腹股沟/大腿内侧疼痛评分方面优于TVT-O组及Tiloop组(P<0.05),差异具有统计学意义;Tiloop组在术后24h疼痛优于TVT-O组及Ajust组(P<0.05),差异具有统计学意义;术后ICIQ-SF评分三组差异均无统计学意义(P>0.05),三组患者术后生活质量、评分较术前均有显著提高(P<0.05),差异具有统计学意义;但三组间比较差异无统计学意义(P>0.05)。结论:经闭孔途径3种不同类型吊带治疗女性压力性尿失禁手术效果无明显统计学差异,3种方式手术方式均简单可靠、微创,术后恢复较好,Ajust手术方式可明显减轻患者腹股沟区疼痛,Tiloop组患者与前两者差异不大,不失为一种简便、安全、有效的微创吊带术式。

Objective： To study the curative effect of three types of trans-obturator tension-free vaginal tape therapy （TVT-O,Adjust,Tiloop） on female patients with stress incontinence. Methods： 78 female patients with stress incontinence in Miyun Teaching Hospital of Capital Medical University from January 2008 to September 2017 were selected and divided into TVT-O group （n = 32）,Adjust group （n = 26） and Tiloop group （n = 20）. The surgery duration,intraoperative blood loss,hospital stay,curative ratio,operative complications,postoperative pain and other perioperative indicators and postoperative indicators including groin/inner thigh pain scores and ICIQ-SF were compared among the three groups. Results： There were no significant differences among the three groups in general information （P〉 0. 05）. There were no significant differences in surgery duration,intraoperative blood loss,postoperative complications and hospital stay among the three groups （P〉 0. 05）. The groin/inner thigh pain score of the Adjust group was better than the TVT-O group and Tiloop group,with statistically significant difference （P〈 0. 05）. The 24 h postoperative pain of the Tiloop group was better than the other two groups,with statistically significant difference （P〈 0. 05）. Differences in the ICIQ-SF among the three groups were not statistically significant （P〉 0. 05）. The quality of life and its score was improved after operation in the three groups with statistically significant difference （P〈 0. 05） but differences among the three groups were not statistically significant （P〉 0. 05）.Conclusions： There is no significant difference among the three types of trans-obturator tension-free vaginal tape therapy for female patients with stress incontinence. All are safe,easy and minimally invasive with fast recovery,where Adjust can effectively reduce groin pain while Tiloop and TVT-O are also safe and effective.