目的:探讨盆腔器官脱垂(POP)伴有下尿路症状患者采用盆底修复手术中行经闭孔尿道中段无张力悬吊带术(TVT-O)治疗的效果.方法:选取2012年1月至2015年3月在湖北省荆州市中心医院实施盆底修复手术治疗的112例患者,根据患者术中是否行TVT-O手术分为TVT-O组(72例)和非TVT-O组(40例),对比两组术后下尿路症状的改善情况.结果:与非TVT-O组比较,TVT-O组患者的手术时间明显延长,术中出血量增多,术后残余尿量减少(P＜0.05).两组患者术后24 h平均体温、住院时间比较,差异无统计学意义(P＞0.05).术前,两组患者尿不尽、尿痛等下尿路症状的发生率及POP-Q分度定量参数测定值比较,差异均无统计学意义(P＞0.05);术后6个月,TVT-O组患者尿不尽、尿痛、手助排尿、尿频、尿急、咳嗽漏尿、点滴漏尿、排尿困难发生率均显著低于非TVT-O组,TVT-O组C点距离、D点距离分别为(-3.7±1.4)cm、(-3.6±1.4)cm,均明显大于非TVT-O组的(-4.4±1.5)cm、(-5.6±1.9)cm,差异均有统计学意义(均P＜0.05).结论:POP伴有下尿路症状患者在盆底修复手术中行TVT-O治疗能有效改善患者的下尿路症状.%Objective:To investigate the effects of inside-out transobturator tape suspension (TVT-O) technique on pelvic organ prolapse (POP) complicated with lower urinary tract symptoms during pelvic floor repair surgery.Methods:From January 2012 to March 2015,112 patients underwent pelvic floor repair surgery in our hospital were selected and divided into non-TVT-O group (40 cases) and TVT-O group (72 cases).Postoperative urinary tract symptoms were observed and compared.Results: Patients in TVT-O group had shorter operation time,higher postoperative residual urine volume,and lower blood loss volume,compared with non-TVT-O group (P＜0.05).There were no significant differences in the average temperature at 24 h post-operation,and hospital days between the two groups (P＞ 0.05).Before surgery,the incidence of lower urinary tract symptoms including urinary endless,dysuria,etc.and POP-Q grading were similar in the two groups (P＞ 0.05).After 6 months of surgery,the incidence of lower urinary tract symptoms including urinary endless,dysuria,frequent urination,etc.in TVT-O group was significantly lower than that in non-TVT-O group (P＞ 0.05).The distance of C point and D point in TVT-O group was significantly higher than that in non TVT-O group (P＜0.05).Conclusion:TVT-O technique application in pelvic floor repair surgery could improve lower urinary tract symptoms in POP patients.
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