摘要
目的 :使用尿垫试验及调查表评价前列腺癌根治术后患者的尿失禁情况 ,观察尿失禁对生活质量的影响 ,研究保留尿道括约肌及患者年龄对术后尿失禁发生率的影响。 方法 :使用尿垫试验及调查表对 16 5例经耻骨后前列腺根治术患者进行连续性的 12～ 14个月的随访调查。患者保持与专职尿失禁护士的电话或直接联系 ,并于术后 12个月到门诊填写调查表、进行尿垫试验。按手术方法将病例分为括约肌修复组 (19例 )和括约肌保留组 (14 6例 ) ,对照观察效果 ;对年龄进行分组 (5 1～ 6 0岁组和 6 1～ 70岁组 )比较累积尿控制率的差异。 结果 :16 5例患者均获随访 :填写调查表并进行尿垫试验 ,7例患者回答使用尿垫而诊断为尿失禁 ,其中 1例有严重尿失禁 ,生活质量受到严重影响 ,其余 6例尿失禁轻 ,生活质量影响轻微 ;尿垫试验中 5例患者尿垫重量增加超过 1g而诊断为尿失禁 ,尿垫试验结果和调查表结果在诊断尿失禁上取得了 98.8%的一致率。按照尿失禁的一般诊断标准 ,本研究中尿道外括约肌保留组随访 12 + 个月时尿控率为 99.3% ,括约肌修复组为 94 .7% ;5 1～ 6 0岁组在刚拔除导尿管时 ,6 0 %的患者有尿失禁 ;6 1～ 70岁组在刚拔除导尿管时 ,82 %的患者有尿失禁 ,但在 3个月以后 ,两组趋于一致。 结论
Objective: To confirm urinary incontinence after radical retro-pubic prostatectomy by questionnaire and pad-test,observe the influence of radical prostatectomy on the patient's quality of life (QOL), and study the effect of urethral sphincter preservation and the patient's age on incontinence. Methods: Questionnaire and pad-test were conducted in 165 consecutive prostate cancer patients who underwent radical prostatectomies. The mean follow-up time was 13 months (12～14 months). Each patient was kept in contact with our incontinence advisor by telephone or direct interview. At 12 months after operation,the patients were asked to the clinic to fill in the questionnaire and underwent the pad-test. In accordance to different operative techniques,the patients were divided into a sphincter repairing group (19 cases) and a sphincter preservation group(146 cases). Results: All the 165 patients were kept in contact with us,underwent the pad-test and filled in the questionnaire. Of the 7 patients diagnosed as incontinence for admitting using pads,only 1 had urinary leakage,and the other 6,who did not use pads very often,showed slight change of QOL. In the pad-test,5 patients were considered to be incontinent since the pad weight gained >1 grams. Between the questionnaire and the pad-test there was a high concordant rate ( 98.8 %). Within 3 months after operation,younger patients seemed to return to continence sooner. The continence rate at 12 months after operation was 99.3 % in the sphincter preservation group and 94.7 % in the sphincter-repairing group. The incontinence rates at the removal of the urinary catheter after operation were 60% and 82% in patients aged 51～60 and 61～70,respectively. At 3 months after operation,the incontinence rates were similar in both groups. Conclusion: Both the questionnaire and the pad-test are recommendable in the assessment of post-operative incontinence since it can accurately document patients' incontinent status. Preservation of the urethral sphincter and its possible innervations can improve the incontinence rate. Younger patients seem to return to continence sooner than the elders.
出处
《中华男科学杂志》
CAS
CSCD
2004年第7期499-502,共4页
National Journal of Andrology
