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目的通过对经闭孔经阴道前壁尿道悬吊术(TVT-O)治疗的女性压力性尿失禁患者进行术前、术后生活质量及盆底功能评分,探讨TVT-O手术的短期临床效果。方法选取2010年1月至2012年4月在郑州大学第三附属医院行TVT-O手术治疗的中、重度压力性尿失禁患者103例,其中单纯性压力性尿失禁患者73例,进行完整随访的72例,对其术前、术后1、3、6个月和12个月分别行盆底功能障碍问卷(PFDI-20)、尿失禁影响问卷简版(IIQ-7)、盆底障碍影响简易问卷(PFIQ-7)及盆底脏器脱垂/尿失禁性功能问卷(PISQ-12)的评分。对评分结果进行总结。结果术后不同时间PFDI-20、IIQ-7、PFIQ-7、PISQ-12的评分与术前比较差异均有统计学意义(P均﹤0.01)。其中PFDI-20、IIQ-7、PFIQ-7生活质量评分在术前、术后1、3个月呈递降(P<0.01或P<0.05),术后6、12个月则稳定在与3个月相近的水平(P均>0.05);PISQ-12的评分术后6个月与术前比较无变化(P>0.05),术后12个月明显升高(P<0.01)。结论 TVT-O治疗可提高女性压力性尿失禁患者的生活质量,疗效在术后3～6个月达到稳定,对性生活质量的影响是可逆的。
Objective To evaluate the short-term clinical effects of TVT-O surgery by assessing preoperative and postoperative quality of life and pelvic floor function in women with stress urinary incontinence who underwent transvaginal transurethral anterior urethral suspension (TVT-O) . Methods From January 2010 to April 2012, 103 patients with moderate-to-severe urinary incontinence underwent TVT-O operation in the Third Affiliated Hospital of Zhengzhou University. Among them, 73 patients with simple stress urinary incontinence were followed up for complete follow-up (PFDI-20), urinary incontinence impact questionnaire (IIQ-7), pelvic floor disorder The impact of simple questionnaire (PFIQ-7) and pelvic organ prolapse / urinary incontinence function questionnaire (PISQ-12) score. Summarize the rating results. Results The scores of PFDI-20, IIQ-7, PFIQ-7 and PISQ-12 at different time points after operation were significantly different from those before operation (all P <0.01). The quality of life scores of PFDI-20, IIQ-7 and PFIQ-7 were decreased preoperatively and 1, 3 months after operation (P <0.01 or P <0.05) (P> 0.05). The score of PISQ-12 had no change at 6 months after operation compared with that before operation (P> 0.05) and at 12 months after operation (P <0.01). Conclusion TVT-O treatment can improve the quality of life of female stress urinary incontinence patients. The curative effect is stable at 3 to 6 months after operation and the effect on sexual life quality is reversible.