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目的:观察耻骨后膀胱颈悬吊术(Raz术)和经闭孔经阴道无张力尿道中段悬吊术(TVT-O术)治疗重度女性压力性尿失禁的疗效。方法:对64例重度女性压力性尿失禁患者分为2组,分别用Raz术治疗患者31例,TVT-O术治疗患者33例,对术中情况分析及治疗后的效果进行定期随访。结果:Raz术治疗的有效率为87.09%,TVT-O术治疗的有效率为90.90%。差异无统计学意义(P>0.05)。Rza术平均手术时间约80min,术中出血约150ml,术后并发症:尿潴留4例,术中损伤膀胱3例;TVT-O术平均手术时间约20min,术中出血约50ml,术后无膀胱损伤、尿潴留并发症。结论:Raz术和TVT-O术相比,疗效均显著,但后者比前者具有损伤小,操作简单,出血少,手术时间短,恢复快等优点。
OBJECTIVE: To observe the curative effect of Raz technique and transthoracic transurethral tension-free middle urethral suspension (TVT-O) on severe female stress urinary incontinence. Methods: Sixty-four patients with severe female stress urinary incontinence were divided into two groups. Twenty-one patients were treated with Raz and 33 patients were treated with TVT-O respectively. The intraoperative situation and the effect of treatment were regularly followed up. Results: The effective rate of Raz surgery was 87.09% and that of TVT-O surgery was 90.90%. The difference was not statistically significant (P> 0.05). The average operation time of Rza operation was about 80min, the intraoperative bleeding was about 150ml. The postoperative complications were as follows: urinary retention in 4 cases and intraoperative injury of bladder in 3 cases. The average operation time of TVT-O operation was about 20min and the intraoperative bleeding was about 50ml. Bladder injury, urinary retention complications. Conclusion: Compared with TVT-O, Raz has significant curative effect, but the latter has the advantages of less damage, simple operation, less bleeding, shorter operation time and faster recovery than the former.