TVT-O手术治疗压力性尿失禁的临床疗效分析

Clinical Efficacy of TVT-O in the Treatment of Stress Urinary Incontinence

目的分析TVT-O手术治疗压力性尿失禁患者的临床疗效。方法选取52例2015年1月-2018年5月在该院治疗的压力性尿失禁患者,对其均行TVT-O手术治疗,观察并比较该组患者治疗前后生活质量评分、尿流动力学指标、腹压漏尿点压力(ALPP)、最大尿道关闭压(MUCP)及治疗效果。结果该组患者手术时间为24~37 min,平均(30.1±2.4)min,术中出血量均少于35 mL;该组52例患者中,48例均获得满意控尿,均未出现复发及其他并发症;该次治疗效果显著,该组患者术后1年I-QOL、P-ISQ评分均优于治疗前,差异有统计学意义(t=21.303、5.624,P<0.05);术后12月ALPP(133.4±25.7)cmH2O、MUCP(54.6±19.7)cm H2O、残余尿量(5.1±2.7)m L/s等指标与治疗前ALPP(65.8±19.3)cmH2O、MUCP(40.2±18.1)cmH2O、残余尿量(4.2±1.6)m L/s相比较,均有明显改善,差异有统计学意义(t=25.194、7.006、3.597,P<0.05),术后12月最大膀胱容量与治疗前对比,差异无统计学意义(t=0.347,P>0.05)。结论临床上治疗压力性尿失禁患者时,采用TVT-O手术治疗,创伤小,并发症少,患者术后恢复的比较快,效果显著,有推广价值。

Objective To analyze the clinical efficacy of TVT-O surgery in the treatment of patients with stress urinary incontinence. Methods A total of 52 patients with stress urinary incontinence who were treated in the hospital from January 2015 to May 2018 were enrolled. All patients underwent TVT-O surgery. The quality of life scores and urodynamics before and after treatment were observed and compared. Index, abdominal pressure leak point pressure(ALPP),maximum urethral closure pressure(MUCP) and treatment effect. Results The operation time of this group was 24-37 min, with an average of(30.1±2.4) min, and the intraoperative blood loss was less than 35 mL. Of the 52 patients in this group, 48 patients were all satisfied with urine control, and no recurrence and other complications;the effect of this treatment was significant. The scores of I-QOL and P-ISQ in this group were better than those before treatment, and the difference was significant(t=21.303, 5.624, respectively, P<0.05);ALPP(133.4±25.7) cm H2O, MUCP(54.6±19.7)cmH2O, residual urine volume(5.1±2.7)mL/s indicators compared with those before treatment ALPP(65.8±19.3) cm H2O,MUCP(40.2±18.1)cmH2O compared with the residual urine volume(4.2±1.6) m L/s, and the difference was significant(t=25.194, 7.006, 3.597, P<0.05). The maximum bladder volume in the 12 months after surgery was compared with that before treatment, with not statistically significant difference(t =0.347, P >0.05). Conclusion Clinically, patients with stress urinary incontinence are treated with TVT-O surgery. The trauma is small and the complications are few. The recovery of patients is faster, the effect is significant, and there is promotion value.