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目的探讨经耻骨上膀胱尿道悬吊术(SPARC)治疗女性压力性尿失禁术后并发症的防治。方法2002年7月-2006年1月,采用SPARC治疗女性压力性尿失禁18例,年龄35-68岁,平均49岁。病程2-19年,平均8年。轻度6例,中度8例,重度4例。结果手术时间25-50 min,平均35 min。出血量15-40 ml,平均30 ml。住院3-14 d,平均5 d。术中膀胱穿孔1例,经留置导尿管2周后治愈。1例术后排尿困难及尿潴留,在门诊行尿道扩张8次后治愈。1例术后3年出现吊带穿破膀胱及膀胱结石形成,经腔镜下膀胱结石碎石后行开放手术将膀胱内吊带切除。余17例随访3-6个月,2例增加腹压时轻度尿失禁,其余15例均排尿通畅,无漏尿及其他并发症。结论SPARC术中术后注意细心操作和正确及时处理,可以有效降低术后并发症的发生率。
Objective To investigate the prevention and treatment of postoperative complications of female stress urinary incontinence by suprapubic cystoral urethral suspension (SPARC). Methods From July 2002 to January 2006, 18 cases of female stress urinary incontinence were treated with SPARC, aged from 35 to 68 years, with an average of 49 years. Duration of 2-19 years, an average of 8 years. 6 cases were mild, 8 cases were moderate and 4 cases were severe. Results The operation time was 25-50 min with an average of 35 min. Bleeding volume 15-40 ml, an average of 30 ml. Hospitalization 3-14 d, an average of 5 d. Intraoperative bladder perforation in 1 case, after catheter indwelling 2 weeks after cure. One case of dysuria and urinary retention after surgery in the outpatient urethral dilation 8 times cured. One case occurred 3 years after surgery to wear the bladder to wear the bladder and bladder stones. After the endoscopic treatment, the bladder stones were removed and the bladder was excised. The remaining 17 cases were followed up for 3-6 months. Two patients had slight urinary incontinence while abdominal pressure was increased. The remaining 15 patients had voiding, no leakage of urine and other complications. Conclusion Careful operation and accurate and timely treatment of postoperative SPARC surgery can effectively reduce the incidence of postoperative complications.