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艾贵海,李怀芳,王建军,等.经闭孔无张力阴道吊带术的解剖学研究[J].同济大学学报（医学版）,2012,33(1):43-47. [点击复制]
- AI Gui-hai,LI Huai-fang,WANG Jian-jun,et al.Anatomical study on procedure of transobturator tension-free vaginal tape[J].同济大学学报（医学版）,2012,33(1):43-47. [点击复制]
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| 经闭孔无张力阴道吊带术的解剖学研究 |
| 艾贵海1,李怀芳2,王建军2,成佳景1,吴逸1,童晓文2 |
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| (1. 同济大学附属第十人民医院妇产科,上海,200072;2. 同济大学附属同济医院妇产科,上海,200065) |
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| 摘要: |
| 目的明确经闭孔无张力阴道吊带术(transobturator tension-free vaginal tape,TVT-O)的穿刺路径,并评估其在治疗女性压力性尿失禁时的安全性。方法应用红色乳胶分别对2具新鲜女性尸体标本进行桡动脉血管灌注,然后将灌注好的标本保存在1~3℃的冰柜里等待乳胶凝固,5 d后对标本进行手术穿刺和路径解剖,同时测量穿刺针与相关血管、神经和脏器之间的空间距离,最后评估该术式的安全性并计算出其安全的操作范围。结果由内向外的TVT-O穿刺路径不经耻骨后间隙,实验中所有穿刺均未发生副损伤;当穿刺点深入尿道外口内约2.3±0.2 cm时可能进入盆腔;此外,穿刺针与闭孔血管神经束出闭膜管处的距离为2.6±0.4 cm,当穿刺针平面与尿道轴夹角小至约26±2度时可能损伤闭孔血管神经束。结论由内向外的TVT-O穿刺路径比较稳定,不经耻骨后间隙,大大地降低了经耻骨后无张力阴道吊带术的术中损伤风险。 |
| 关键词: 经闭孔无张力阴道吊带术 压力性尿失禁 尸体 解剖 |
| DOI：10.3969/j.issn1008-0392.2012.01.009 |
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| 基金项目: |
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| Anatomical study on procedure of transobturator tension-free vaginal tape |
| AI Gui-hai1,LI Huai-fang2,WANG Jian-jun2,CHENG Jia-jing1,WU Yi1,TONG Xiao-wen2 |
| (1.Dept.of Gynecology and Obstetrics,Tenth People’s Hospital,Tongji University,Shanghai 200072,China;2.Dept.of Gynecology and Obstetrics,Tongji Hospital,Tongji University,Shanghai 200065,China) |
| Abstract: |
| Objective To identify the operative route of transobturator tension-free vaginal tape (TVT-O) for stress urinary incontinence(SUI),and to evaluate its safety.Methods Two fresh cadavers were injected with colored latex from radial artery,TVT-O procedures were performed when lactoprene was solidified 5 days after injection.The measurements between the trocars and related vessels,nerves and organs were carried out;the safety was evaluated and the safety range was worked out from the measured data.Results The route of TVT-O inside-out operation did not pass through the retropubic space,and there was no complication during all procedures.When the beginning point was too deep into the anterior vaginal wall,about(2.3±0.2) cm proximal to urethral meatus,the trocar would enter into the pelvic cavity.In addition,the distance between TVT-O trocar and obturator canal was about(2.6±0.4) cm,when the included angle between the plane of TVT-O needle and urethral sagittal plane was about 26±2 degree,the trocar would damage the obturator vessels and nerve.Conclusion The route of TVT-0 inside-out operation is stable and the retropubic space is not violated,which may reduce the risk of injury. |
| Key words: transobturator tension-free vaginal tape stress urinary incontinence cadaver anatomy |