摘要
目的探讨改良盆底重建术对治疗女性压力性尿失禁的效果。方法选择2014年1月至2015年1月在南京军区总医院接受手术治疗的伴有盆底脱垂的压力性尿失禁女性患者65例为研究对象,对伴有盆底脱垂的压力性尿失禁女性患者实施改良盆底重建术,进行疗效评估和1年的随访,并对结果进行分析。结果所有65例患者均顺利完成手术,手术时间为(82.14±23.65)min,出血量为(57.14±14.22)m L;手术成功率达100%。有63例患者达到远期治愈,总治愈率为96.92%,患者总体满意率为100%。术后随访1年,结果显示患者手术后性生活满意度、生活质量、社交情况、排尿情况、情绪影响等明显得到改善(t值分别为2.160、7.555、10.092、12.067、20.688,均P<0.05);术后Grouts-Blaivas评分,65例患者尿失禁症状明显改善,有2例患者剧烈活动偶有漏尿。术后盆腔器官脱垂评分(POP-Q)分度评价,无脱垂者62例,Ⅰ度脱垂者3例。65例患者术后早期并发症主要有:股部疼痛8例,发生率为12.31%;排尿困难5例,发生率7.69%;排尿姿势改变4例,发生率6.15%。结论改良盆底重建手术能够有效维持腹压增加时的尿道闭合压,避免压力性尿失禁发生,手术具有操作简单、并发症少、安全可靠等优点。
Objective To investigate the effect of improved pelvic floor reconstruction on female stress urinary incontinence. Methods Sixty-five patients who had stress urinary incontinence with pelvic floor prolapse received surgeries in Nanjing General Hospital from January2014 to January 2015,and they were selected as the subjects to receive the improved pelvic floor reconstruction surgeries. The therapeutic effects were evaluated and 1-year follow-up was conducted. Results The surgeries of 65 cases were successfully completed. The operation time was 82. 14 ± 23. 65 min,and the amount of bleeding was 57. 14 ± 14. 22 m L. The surgical success rate was 100%. Totally 63 cases obtained long-term cure,and the total cure rate was 96. 92%. The total satisfaction rate was 100%. One-year follow-up showed that the postoperative sexual life satisfaction,quality of life,social situation,micturition situation,and emotional of patients were obviously improved（ t value was 2. 160,7. 555,10. 092,12. 067 and 20. 688,respectively,all P〈0. 05）. The postoperative Grouts-Blaivas score showed the symptoms of incontinence of the cases were obviously improved,and among them 2 cases occasionally presented leakage of urine when doing intense activities. According to postoperative pelvic organ prolapse quantitive（ POP-Q） examination,there were 62 cases without prolapse and 3 cases of grade I. The complications in early postoperative period mainly included femoral pain in 8 cases with the incidence of 12. 31%,difficulty in urination in 5 cases with the incidence of 7. 69%,and micturition posture change in 4 cases with the incidence of 6. 15%. Conclusion The modified pelvic floor reconstruction can effectively maintain the urethral closure pressure when the abdominal pressure is increased and avoid stress urinary incontinence,which has the advantages of simple operation,fewer complications,safety and reliability.
出处
《中国妇幼健康研究》
2016年第8期1024-1026,共3页
Chinese Journal of Woman and Child Health Research
关键词
尿失禁
压力性
改良盆底重建术
近期疗效
远期疗效
urinary incontinence
stress
modified pelvic floor reconstruction
short-term efficacy
long-term efficacy
