中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2013, Vol. 42 ›› Issue (10): 918–923.

• 技术方法 • 上一篇    下一篇

阴道前壁瓣自体移植治疗压力性尿失禁临床探讨

陈涓涓1,夏志军2,许海楠1,秦美英1   

  1. 中国医科大学 1. 研究生院;2. 附属盛京医院妇科盆底病房,沈阳 110000
  • 收稿日期:2013-02-26 修回日期:2013-11-26 出版日期:2013-10-18 发布日期:2013-11-26
  • 作者简介:陈涓涓(1987 -),女,硕士研究生.

Clinical Study about Homograft by Paries Anterior Vaginal Flap for Stress Urinary Incontinence Treatment

CHEN Juan-juan1, XIA Zhi-jun2, XU Hai-nan1, QIN Mei-ying1   

  1. 1. Department of Gynaecology, Shengjing Hospital, China Medical University, Shenyang 110004, China;
    2. Graduate School, China Medical University, Shenyang 110001, China
  • Received:2013-02-26 Revised:2013-11-26 Online:2013-10-18 Published:2013-11-26

摘要:

目的 探讨采用阴道壁瓣(AVWF)自体移植至尿道中路治疗压力性尿失禁的临床疗效。方法 收集压力性尿失禁患者 44例,分成实验组与对照组各22人,实验组行自体移植至尿道中路手术治疗,对照组行尿道中路悬吊手术治疗。根据术后2个月、术后1年的随访,对比两种手术方式的治愈率和术后并发症。结果 术后2月的术后随访调查中,实验组19例患者尿失禁症状完全治愈、2例尿失禁患者术后仍有轻度尿失禁症状,1例尿失禁患者术后症状无明显改善。治愈率为86.36%,22例患者术后均无切口部位感染、膀胱损伤、血肿、术后阴道异物暴露等并发症。对照组术后21例患者症状完全改善,治愈率为95.45%,1例患者有排尿困难症状。根据1年随访结果,实验组21例患者术后尿失禁症状完全治愈、1例尿失禁患者术后症状无明显改善。治愈率为95.45%,22例患者均无切口部位感染、膀胱损伤、血肿、术后阴道异物暴露等并发症。对照组20例患者症状完全改善,1例患者有排尿困难症状,1例患者网片暴露,治愈率为90.91%。结论 与尿道中路悬吊手术比较,阴道前壁瓣移植治疗压力性尿失禁,疗效明确。该手术安全可靠,是减少异物排斥、移植物应用的一种新的治疗压力性尿失禁的手术方法。

关键词: 阴道壁皮瓣, 压力性尿失禁, 手术方法, 自体移植

Abstract:

Objective To investigate the therapeutic efficacy of anterior vaginal wall flap for the treatment of SUI. Methods A total of 44 SUI patients admitted in our department were enrolled in this study, and randomized to two groups.SUI operation using wall anterior vaginal flap as suspending material and upgraded based on Urethral suspension surgery was performed in 22 patients(experiment group), and Urethral suspension surgery was carried out in another 22 patients(control group).The general condition, quality of life and urodynamic study after follow?up of 2 months and one year)operation were compared between two groups. The cure rate was statistically analyzed. Results After 2 months of follow?up survey, among the experimental group, 19 patients with urinary incontinence symptoms were completely cured, 2 cases still have symptoms of mild urinaryin?continence, 1 case without obvious symptoms improvement. The curerate was 86.36%, 22 patients had no post operative surgical site infection, bladder injury, hematoma, post operative complications such as vaginal foreign body exposure. In the control group, 21 patients were completely cured with a rate of 95.45%, there was only 1 patient still had dysuria symptoms;during the 1 year′s follow-up survey, the cure rate was 95.45% of the ex?periment group. None of them had complications such as infection, bladder injury, hematoma, foreign body exposure. In the control group, 20 cases in 22 were cured completely with acurerate of 90.91%.1 case accidentally had misnicturition, and 1 case received mesh remove caused by the mesh invasion. Conclusion Homograft made by PAVF showed a clear effect, which was safe with less complication compared with Urethral suspension surgery as a new technique.

Key words: anteriorvaginalwallflap, stressincontinence, surgicalmethods, autologoustransplantation

中图分类号: 

  • R711

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