本文選題：壓力性尿失禁 + 經(jīng)閉孔路徑陰道無張力尿道中段懸吊術(shù)��； 參考：《蘇州大學(xué)》2014年碩士論文

【摘要】：[目的]評(píng)價(jià)兩種手術(shù)TVT-O和TVT-S治療女性壓力性尿失禁的成功率和并發(fā)癥。 [方法]計(jì)算機(jī)配合手工檢索PUBMED數(shù)據(jù)庫、Cochrane Library、ELSEVIER數(shù)據(jù)庫、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBM)、中國知識(shí)資料總庫(CNKI)、維普(VIP)、萬方數(shù)據(jù)庫等有關(guān)的參考文獻(xiàn)對(duì)比兩種手術(shù)治療女性壓力性尿失禁并發(fā)癥發(fā)生率，語種限于英語和漢語，，文獻(xiàn)檢索起止時(shí)間均從1996年05至2014年03月，同時(shí)檢索納入文獻(xiàn)的參考文獻(xiàn)，納入比較TVT-O和TVT-S術(shù)治療SUI的隨機(jī)對(duì)照試驗(yàn)（RCT），并逐個(gè)進(jìn)行質(zhì)量評(píng)價(jià)和資料提取。剔除不合本文研究目的或不符合納入標(biāo)準(zhǔn)的文章。統(tǒng)計(jì)學(xué)分析采用RevMan5．1軟件對(duì)納入研究進(jìn)行綜合定量評(píng)價(jià)。以患者的治愈率和并發(fā)癥發(fā)生率為中遠(yuǎn)期療效觀察指標(biāo)，包括客觀治愈率、主觀治愈率、術(shù)后尿潴留、術(shù)后新發(fā)尿急癥及術(shù)后吊帶侵蝕/暴露，并計(jì)算各個(gè)研究的RR值，通過合并RR值比較TVT-O組和TVT-S組中1年客觀治愈率、2-3年客觀治愈率、2-3年主觀治愈率、術(shù)后尿潴留、術(shù)后新發(fā)尿急癥及術(shù)后吊帶侵蝕/暴露的發(fā)生率等中遠(yuǎn)期并發(fā)癥。 [結(jié)果]納入7項(xiàng)臨床隨機(jī)對(duì)照試驗(yàn)包括696例病人，TVT-O共312例，TVT-S（H/U）共384例。Meta分析結(jié)果顯示，TVT-O組比較TVT-S組：（1）1年客觀治愈率有顯著性差異（RR=1.20，95%CI(1.12-1.30)，P0.00001）；（2）2-3年客觀治愈率有顯著性差異（RR=1.19，95%CI(1.09-1.29)，P0.0001）；（3）2-3年主觀治愈率有顯著性差異(RR=1.12，95%CI(1.03-1.21)，P=0.009)；（4）術(shù)后尿潴留發(fā)生率無顯著性差異(RR=1.74，95%CI(0.64-4.76)，P=0.28)；（5）術(shù)后新發(fā)尿急癥發(fā)生率無顯著性差異（RR=1.48，95%CI(0.87-2.52)，P=0.15）；（6）術(shù)后吊帶侵蝕/暴露發(fā)生率無顯著性差異（RR=0.61，95%CI(0.27-1.35)，P=0.22)。 [結(jié)論]TVT-O術(shù)式1年、2-3年客觀及主觀治愈率高于TVT-S術(shù)式，術(shù)后尿潴留發(fā)生率、術(shù)后新發(fā)尿急癥發(fā)生率和術(shù)后吊帶侵蝕/暴露發(fā)生率兩者無顯著性差異。
[Abstract]:[objective] to evaluate the success rate and complications of TVT-O and TVT-S in the treatment of female stress urinary incontinence. [methods] the PUBMED database was searched manually by computer. The Chinese Biomedical Literature Database (CBM), China General knowledge Database (CNKI), Weipu VIPA, Wanfang Database and other related references compared the incidence of complications in the treatment of female stress urinary incontinence in two kinds of operations, the languages of which were limited to English and Chinese. The time of beginning and ending of literature retrieval was from May 1996 to March 2014. The references included in the literature were also retrieved, and the randomized controlled trial of TVT-O and TVT-S for the treatment of SUI were included, and the quality evaluation and data extraction were carried out one by one. Eliminate articles that are not in accordance with the purpose of this study or that do not meet the inclusion criteria. Statistical analysis using RevMan5.1 software to carry out comprehensive quantitative evaluation of the inclusion study. The curative rate and complication rate of the patients were taken as the observation index of the middle and long term curative effect, including objective cure rate, subjective cure rate, postoperative urinary retention, postoperative urinal urgency and postoperative sling erosion / exposure, and the RR values of each study were calculated. The objective cure rate in TVT-O group and TVT-S group was compared by combining RR value. The objective cure rate of 2-3 years was compared. The subjective cure rate, postoperative urinary retention, postoperative acute urethra and the incidence of erosion / exposure of sling were compared. [results] A total of 384 patients were enrolled in 7 randomized controlled trials, including 696 patients with TVT-O and 312 patients with TVT-O. Meta-analysis results showed that there was significant difference in objective cure rate of TTV T O group compared with TVT-S group (n = 11). There was no significant difference in the incidence of urinary retention after operation. There was no significant difference in the incidence of urinary retention after operation (RR1.7495CI0.64-4.76CI0.64-4.76). There was no significant difference in the incidence of new acute urethra after operation (RRU 1.4895CIT 0.87-2.52P0.15A) there was no significant difference in the incidence of sling erosion / exposure after operation. [conclusion] the objective and subjective cure rate of TVT-O was higher than that of TVT-S in 2-3 years. There was no significant difference in the incidence of postoperative urinary retention, the incidence of postoperative urinal urgency and the incidence of sling erosion / exposure.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R713

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