[1]王建龙* 李欣 张耀光 刘明 万奔 王建业.经闭孔尿道中段悬吊术治疗高龄女性 压力性尿失禁患者精神状态研究[J].中国微创外科杂志,2015,15(10):913-921.
　Wang Jianlong,Li Xin,Zhang Yaoguang,et al.Psychological Study on TVT-O for Stress Urinary Incontinence in Aged Female Patients[J].Chinese Journal of Minimally Invasive Surgery,2015,15(10):913-921.
点击复制

经闭孔尿道中段悬吊术治疗高龄女性 压力性尿失禁患者精神状态研究()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
15
期数:
2015年10期
页码:
913-921
栏目:
临床研究
出版日期:
2015-10-20

文章信息/Info

Title:
Psychological Study on TVT-O for Stress Urinary Incontinence in Aged Female Patients
作者:
王建龙* 李欣 张耀光 刘明 万奔 王建业
（卫生部北京医院泌尿外科，北京100730）
Author(s):
Wang Jianlong;  Li Xin;  Zhang Yaoguang;  et al.
Department of Urology, Beijing Hospital of Ministry of Health, Beijing 100730, China
关键词:
经闭孔无张力尿道中段悬吊术; 压力性尿失禁; 焦虑; 抑郁
Keywords:
TVT-O; Stress urinary incontinence; Anxiety; Depression
分类号:
R694+.54
摘要:
目的探讨经闭孔无张力尿道中段悬吊术（TVT-O）对高龄女性压力性尿失禁患者精神状态的影响。方法对我科2013年11月~2014年3月20例年龄>75岁女性压力性尿失禁行TVT-O手术，进行术前、术后国际尿失禁咨询委员会尿失禁问卷评分（ICIQ-SF）、尿失禁生活质量问卷评分（I-QOL）、1小时尿垫试验、焦虑自评量表（SAS）评分及抑郁自评量表（SDS）评分，分析手术疗效及并发症发生情况。结果20例术后随访3个月，主观满意率95.0%（19/20），客观有效率850%（17/20），无尿失禁复发。ICIQ-SF评分术前（15.65±1.50）分，术后3个月降至（8.20±1.28）分（t=30.315，P=0000）；I-QOL评分术前（39.25±1.37）分，术后3个月升至（87.40±1.43）分（t=-159.685，P=0.000）。1小时尿垫试验术前漏尿（31.65±18.98）g，术后3个月降至（9.25±17.72）g（t=14.988，P=0.000）。SAS术前（58.70±1.69）分，术后3个月降至（41.80±1.58）分（t=70.559，P=0.000）。SDS术前（57.55±2.39）分，术后3个月降至（40.50±2.01）分（t=35644，P=0.000）。1例术后3天排尿困难，残余尿量>100 ml，留置导尿1周后拔管，排尿通畅。2例腹股沟疼痛，2天、1周自行缓解。术后新发急迫性尿失禁1例，反复泌尿系感染1例。结论TVT-O是治疗高龄女性压力性尿失禁安全有效的方法，结合有效的护理，可以改善患者生活质量及精神状态。
Abstract:
ObjectiveTo discuss changes of mental status in perioperative period of tension free vaginal tape obturator (TVT-O) for stress urinary incontinence in old female patients.MethodsTwenty female stress urinary incontinence patients aged more than 75 years old underwent TVT-O from November 2013 to March 2014 in our hospital. We analyzed surgical outcomes by using preoperative and postoperative International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), incontinence quality of life questionnaire score (I-QOL), one hour urine pad test, Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS) scores.ResultsWe provided follow-up reviews in the twenty female stress urinary incontinence patients after surgery for 3 months. The subjective satisfactory rate was 95.0% (19/20), and the objective of efficiency was 85.0% (17/20). During the follow-up no recurrence of symptoms developed. The International Consultation on Incontinence Questionnaire Short Form score was 15.65±1.50 before the operation and reduced to 8.20±1.28 at 3 months after surgery (t=30.315, P=0.000). The incontinence quality of life questionnaire score was 39.25±1.37 preoperatively and increased to 87.40±1.43 at 3 months after surgery (t=-159.685, P=0000). The one hour urine pad test showed the mean preoperative urine leakage was 31.65±18.98 g and decreased to 9.25±17.72 g at 3 months after operation (t=14.988, P=0.000). The Self-rating Anxiety Scale was 58.70±1.69 before the operation and reduced to 41.80±1.58 after 3 months (t=70.559, P=0.000). The Self-rating Depression Scale was 57.55±2.39 before the operation and reduced to 40.50±2.01 after 3 months (t=35.644, P=0.000). One patient had dysuria 3 days after surgery and obtained recovery after keeping catheterization for one week. Two patients had groin thigh pain which remitted after two days to one week. There were 1 case of urge urinary incontinence and 1 case of urinary infection after surgery.ConclusionsTVT-O is an effective and safe way to treat old female stress urinary incontinence. The treatment combined with careful nursing can improve the quality of life and psychological status of the patients.

参考文献/References:

[1]Lee KS,Han DH,Choi YS,et al.A prospective trial comparing tension-free vaginal tape and transobturator vaginal tape inside-out for the surgical treatment of female stress urinary incontinence:1-year followup.J Urol,2007,177(1):214-218.
[2]De Leval J.Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out.Eur Urol,2003,44(6):724-730.
[3]那彦群,叶章群,孙光.中国泌尿外科疾病诊断治疗指南.北京:人民卫生出版社,2011.154-156.
[4]廖利民,Werner Schaefer.尿动力学质量控制(II):典型信号模式的识别及其在实时定性质量控制中的作用.中华泌尿外科杂志,2006,27(5):300-303.
[5]Syan R,Brucker BM.Guidelines of Guidelines:Urinary Incontinence.BJU Int,2015.［Epub ahead of print］
[6]Staskin D,Hilton P.Initial assessment of incontinence. In: 3th International Consultation of Incontinence.Monte Carlo Manaco,2004.485-518.
[7]Avery K,Donovan J,Peters TJ,et al.ICIQ:a brief and robust measure for evaluating the symptoms and impact of urinary incontinence.Neurourol Urodyn,2004,23(4):322-330.
[8]Patrick DL,Martin ML,Bushnell DM,et al.Quality of life of women with urinary incontinence: further development of the incontinence quality of life instrument (I-QOL).Urology,1999,53(1):71-76.
[9]Yu SB,Hu W,Zhao QY,et al.Effect of anxiety and depression on the recurrence of persistent atrial fibrillation after circumferential pulmonary vein ablation.Chin Med J (Engl),2012,125(24):4368-4372.
[10]金辛良,任淑梅.无张力性阴道吊带治疗女性压力性尿失禁的临床疗效.中华泌尿外科杂志,2005,26(5):337-339.
[11]朱亚飞,何林生.TVT治疗单纯性女性压力性尿失禁临床疗效的荟萃分析.循证医学,2007,7(2):84-91.
[12]中华医学会妇产科学分会妇科盆底学组.女性压力性尿失禁诊断和治疗指南(试行).中华妇产科杂志,2011,46(10):796-798.
[13]Frick AC,Huang AJ,Van den Eeden SK,et al.Mixed urinary incontinence: greater impact on quality of life.J Urol,2009,182(2):596-600.
[14]Coyne KS,Kvasz M,Ireland AM,et al.Urinary incontinence and its relationship to mental health and health-related quality of life in men and women in Sweden, the United Kingdom, and the United States.Eur Urol,2012,61(1):88-95.
[15]Waltregny D.TVT-O:a new gold standard surgical treatment of female stress urinary incontinence.Eur Urol,2013,63(5):879-880.
[16]王文艳,朱兰,郎景和,等.TVT与TVT-O手术治疗压力性尿失禁的前瞻性随机对照研究.中华医学杂志,2011,91(13):898-901.
[17]Serati M,Bauer R,Cornu JN,et al.TVT-O for the treatment of pure urodynamic stress incontinence:efficacy,adverse effects,and prognostic factors at 5-year follow-up.Eur Urol,2013,63(5): 872-878.
[18]潘慧仙,胡俊杰,许晓源,等.TVT-O治疗女性混合性尿失禁的疗效观察.中国微创外科杂志,2014,14(9):819-821.

备注/Memo

备注/Memo:
*通讯作者，E-mail：wjlspplaaa@sina.com
更新日期/Last Update: 2016-02-03