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目的探讨伴有尿失禁(urinary incontinence,UI)症女性患者行全髋关节置换术(total hip arthroplasty,THA)对原有UI症的影响。方法选取2012年9月至2014年6月于暨南大学附属第一医院因股骨头坏死行THA治疗的88例女性患者,用国际UI调查问卷(ICI-Q-SF)对患者UI情况分别于术前及术后6个月进行评价,将患者分为术前有UI组和非UI组,采用Harris评分对髋关节功能于术前及术后6个月进行评价,评估髋部功能的改善对女性UI症状的影响及临床关系。结果共有37例患者术前有UI症状,术后UI症状改善患者26例,未见明显变化的患者10例,有1例出现症状加重。UI组与非UI组患者术前及术后髋关节Harris评分比较差异无统计学意义(P>0.05)。UI组患者术后ICI-Q-SF评分较术前明显下降,差异有统计学意义(P<0.05)。结论女性UI与髋部盆底结构功能具有相关性,女性UI患者行THA提高髋关节功能后有改善UI症状的迹象,可不必积极同时行抗UI手术,注意观察,必要时再酌情在尿道中段手术悬吊尿道。
Objective To investigate the effect of total hip arthroplasty (THA) on the original UI in female patients with urinary incontinence (UI). Methods Eighty-eight female patients undergoing THA for the treatment of femoral head necrosis at the First Affiliated Hospital of Jinan University from September 2012 to June 2014 were enrolled in this study. The UI of the patients with ICI-Q-SF was compared with that of the patients with THA Before and after 6 months, the patients were divided into preoperative UI group and non-UI group, the Harris score was used to evaluate the function of hip joint before and 6 months after operation to evaluate the improvement of hip function. Influence of female UI symptoms and clinical relationship. Results A total of 37 patients had preoperative UI symptoms, postoperative UI symptoms improved in 26 patients, no significant changes in 10 patients, 1 patients with symptoms worsened. There was no significant difference in Harris score between preoperative and postoperative hip joint between UI group and non-UI group (P> 0.05). The ICI-Q-SF score in the UI group was significantly lower than that before the operation, the difference was statistically significant (P <0.05). Conclusions There is a correlation between female UI and hip pelvic floor structure and function. Female UI patients may show signs of improving UI symptoms after THA improves hip joint function. It is not necessary to take active anti-UI surgery simultaneously. Attention should be paid to the observation and, if necessary, Surgical suspension of the urethra.