摘要
目的探讨一种国产聚丙烯尿失禁吊带治疗女性压力性尿失禁(SUI)的有效性及安全性。方法纳入2022年11月至2023年12月于中国医学科学院北京协和医院因SUI行国产聚丙烯尿失禁吊带手术患者共43例,平均年龄(52.8±10.6)岁,其中7例同时进行抗盆腔器官脱垂(POP)手术。收集患者围术期并发症情况及术后随访情况,采用患者全身状况改善问卷(PGI-I)、泌尿生殖障碍量表简版(UDI-6)及尿失禁影响问卷简版(IIQ-7)评估患者症状改善情况,治疗成功定义为PGI-I问卷明显改善或有改善,且UDI-6问卷得分较术前改善超过70%。利用Wilcoxon符号秩和检验比较UDI-6、IIQ-7问卷术前术后评分情况。结果围手术期1例患者膀胱侧方血肿形成,无膀胱损伤、大出血等并发症出现。术后1年治疗成功率为81.1%(30/37);3例(7.0%)患者出现吊带暴露,2例门诊剪除,1例手术拆除;1例(2.3%)患者报告了疼痛症状;4例(9.3%)患者出现轻度新发急迫症状。UDI-6及IIQ-7问卷术后1年与术前评分相比均降低,差异有统计学意义[UDI-6:41.8(29.3,58.3)分vs.0(0,8.6)分,P<0.01;IIQ-7:32.0(0,52.0)分vs.0(0,0)分,P<0.01]。结论国产聚丙烯尿失禁吊带与国外同类产品有效性相仿,围术期无严重并发症发生,网片暴露率稍高,需进一步关注。
Objective To evaluate the efficacy and safety of a domestically produced polypropylene sling for treating female stress urinary incontinence(SUI).Methods This study analyzed 43 patients who underwent the domestic polypropylene sling procedure at Peking Union Medical College Hospital between November 2022 and December 2023[mean age(52.8±10.6)years],including 7 cases with concurrent anti-pelvic organ prolapse surgery.Perioperative complications and postoperative follow-up data were collected.Treatment outcomes were assessed using the Patient Global Impression of Improvement(PGI-I),Urinary Distress Inventory-6(UDI-6),and Incontinence Impact Questionnaire-7(IIQ-7).Treatment success was defined as a response of very much better or much better on PGI-I and a reduction in the score on the UDI-6 of≥70%.The Wilcoxon rank test was performed to compare pre-and postoperative questionnaire scores.Results One case(2.3%)was found lateral bladder hematoma perioperatively,and no bladder injury or major hemorrhage was found.The rate of treatment success at 1 year was 81.1%(30/37).Sling exposure occurred in 3 cases(7.0%),and of them,2 were managed by office trimming and 1 was managed by surgical removal.One patient(2.3%)reported mild pain,and 4(9.3%)developed mild de novo urgency symptoms.Both UDI-6 and IIQ-7 scores showed significant improvement after operation(UDI-6:41.8[29.3,58.3]scores vs.0[0,8.6]scores,P<0.01;IIQ−7:32.0[0,52.0]scores vs.0[0,0]scores,P<0.01).Conclusions The domestic polypropylene sling demonstrates comparable efficacy to international counterparts,with no major perioperative complications observed.A slightly higher mesh exposure rate warrants further investigation.
作者
尹汝莎
曹杨
朱兰
YIN Ru-sha;CAO Yang;ZHU Lan(Department of Obstetrics and Gynecology,National Clinical Research Center for Obstetric&Gynecologic Diseases,State Key Laboratory of Common Mechanism Research for Major Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China.)
出处
《中国实用妇科与产科杂志》
2025年第12期1236-1239,共4页
Chinese Journal of Practical Gynecology and Obstetrics
基金
国家重点研发计划(2023YFC2706000,2023YFC2706001)
中央高水平医院临床科研业务费(2022-PUMCH-B-087)。
