摘要
目的系统评价单切口经阴道尿道中段悬吊术（TVT-S）与闭孔路径无张力尿道中段悬吊术（TVT-O／TOT）治疗压力性尿失禁的临床疗效和安全性。方法计算机配合手工检索万方数据库、CNKI、CBM、VIP、MEDLINE、OVID、FMJS、Cochrane Library中，从1996年11月到2012年3月TVT．S和TVT-O／TOT的随机对照试验文献。按Cochrane系统评价方法，采用Revman5．1．0进行荟萃分析。结果共纳入7项研究，共1545例患者。荟萃分析结果显示TVT．S与TVT／TOT相比，术后排空障碍[RR=0．68，95％CI（0．37-1．26），P〉0．05]和性交疼痛[PaY=2．60，95％CI（0．88-7．68），P〉0．05]发生率差异无统计学意义，但客观治愈率[RR：0．86，95％CI（0．78-0．93），P〈0．05]、再次手术率[RR=2．51，95％CI（1．51-4．17），P〈0．05]、术后大腿内侧及腹股沟区疼痛[RR=0．06，95％c，（0．02-0．20），P〈0．05]及新发尿路急迫[RR=3．01，95％CI（1．37-6．59），P〈0．05]发生率差异均有统计学意义。结论TVT-S虽然减低了TVT-O／TOT大腿内侧及腹股沟区疼痛发生率，但其客观治愈率相对较低，且术后新发尿路急迫症状和再次手术风险相对较高。
Objective To assess the current evidence of effectiveness and safety of Single-incision mini-slings （TVT-S） versus transobturator tension-free vaginal tapes （TVT-O/TOT） in the management of female stress urinary incontinence （SUI）. Methods Literature searches were conducted for all randomized controlled trials （RCTs） comparing TVT-S and TVT-O/TOT from CNKI, CBM, VIP, MEDLINE, OVID, FMJS and Cochrane Library between November 1996 and November 2011. The Revman 5.1.0 software was used for Meta-analysis according to Cochrane system evaluation method. Results A total of 1545 females in 7 RCTs were included. Meta-analysis showed that no statistical differences existed in the rate of postoperative voiding dysfunction and dyspareunia between TVT-S and TVT-O/TOT （P 〉 0.05 ）. But the rate of objective cure, re-operation, inner thigh and groin pain and de novo urgency were statistically significant （ P 〈 0.05 ）. Conclusion As compared with TVT-O/TOT, TVT-S procedure is associated with less postoperative inner thigh and groin pain, but a lower objective cure rate and relatively higher rates of de novo urgency and re- ooeration.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2012年第37期2632-2635,共4页
National Medical Journal of China
基金
福建省科技创新平台（2010Y2005）
福建省青年人才资助（2008F3087）
关键词
尿失禁
压力性
妇科外科手术
循证医学
Urinary incontinence, Stress
Gynecologic surgical procedures
Evidence-basedmedicine
