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目的:评价改良自制聚丙烯网片及弹力钉的无张力尿道中段悬吊术(tension-free viginaI tape,TVT)治疗女性压力性尿失禁(stress udnary incontinence,SUI)的安全性和治疗效果。方法:选择2010年1月～2011年1月确诊为SUI患者60例,分为两组,改良组30例,采用自制聚丙烯网片及弹力钉的无张力尿道中段悬吊术(改良TVT术);对照组30例采用TVT术。对两组术中情况及术后疗效举行定期随访,对比分析。结果:两组患者均在硬膜外麻醉下完成手术。术后7天统计,两组有效率比较差异无统计学意义(χ2=0.1113,P>0.05);在手术时间、出血量、住院时间方面,两组患者比较,差异无统计学意义(P>0.05);治疗费用方面,两组比较差异有统计学意义(P﹤0.01)。手术前后尿失禁次数、尿流率、B超测定残余尿量、国际尿失禁咨询委员会尿失禁问卷表简表(ICI-Q-SF)评分等指标方面,两组比较差异无统计学意义(P>0.05)。全部病例术后无出血、血肿、切口感染及网片排异反应。结论:改良自制聚丙烯网片及弹力钉的TVT术方法简单、操作安全、悬带调节方便,疗效与传统TVT术相当,而且其治疗费用低廉,易为患者接受。
Objective: To evaluate the safety and efficacy of tension-free vigina tape (TVT) for the treatment of female stress urinary incontinence (SUI) with modified self-made polypropylene mesh and elastic nail. Methods: Sixty patients diagnosed as SUI from January 2010 to January 2011 were divided into two groups, 30 cases in the modified group. The patients underwent tension-free urethral mid-section suspension with self-made polypropylene mesh and elastic nail (modified TVT ); Control group, 30 cases were treated with TVT. The two groups of intraoperative and postoperative efficacy of regular follow-up, comparative analysis. Results: Both groups underwent surgery under epidural anesthesia. There was no significant difference in the effective rate between the two groups (χ2 = 0.1113, P> 0.05) at 7 days after operation. There was no significant difference between the two groups in operation time, blood loss and hospital stay (P> 0.05). There was significant difference between the two groups in treatment cost (P <0.01). There were no significant differences between the two groups in the number of urinary incontinence, urinary flow rate, residual urine volume measured by B-ultrasound and ICI-Q-SF score (P < > 0.05). All cases without hemorrhage, hematoma, incision infection and reticular rejection. Conclusion: The modified TVT with self-made polypropylene mesh and elastic nail is simple, safe and easy to adjust. The curative effect is equivalent to that of traditional TVT. And its therapeutic cost is low and it is easy for patients to accept.