托特罗定治疗壁内段输尿管结石所致膀胱激惹症状的疗效研究  

Efficacy of tolterodine for medical treatment of intramural ureteral stone with vesical irritability

作　　者：唐庆来[1] 吕建林[1] 惠继红[1] 周兴祝[1] 柳发德[1] 王义兆[1] 贾春萍[1] 王杜渐[1] 

机构地区：[1]南京医科大学附属江宁医院泌尿外科,江苏南京211100

出　　处：《东南大学学报（医学版）》2013年第3期275-278,共4页Journal of Southeast University(Medical Science Edition)

基　　金：南京市卫生局青年启动项目(YK11229)

摘　　要：目的:探讨托特罗定治疗壁内段输尿管结石所致膀胱激惹症状的疗效。方法:选取2007年12月至2012年6月间共282例壁内段输尿管结石患者作为研究对象,并将其分为两组。A组为对照组,共140例,给予观察等待;B组为治疗组,共142例,给予托特罗定2 mg,每日2次,共2周。比较两组结石的排出率、排石时间、疼痛次数和止痛剂的应用等。患者每次排尿时应用排尿感觉量表(USS)进行记录,以表示尿急的发生率。应用视觉模拟量表(visual analog scale,VAS)疼痛评分来记录患者的疼痛程度。结果:A组和B组的结石排出率分别为56.4%和57.0%。两组平均肾绞痛发作次数分别为4.7和1.7。两组在第3天和第7天USS量表平均评分分别为2.76、1.32和1.90、1.18。两组间VAS评分亦有显著差异。结论:托特罗定对壁内段输尿管结石排石率并无提高,但它能减少此类患者的尿频、尿急症状,减轻疼痛的强度和不适感。Objective： To study the efficacy of tolterodine for medical treatment of intramural ureteral stone with vesical irritability. Methods： A total of 282 patients with intramural ureter stones were included in the study from December 2007 to June 2012.Patients were randomly divided into two groups.There were 140 patients in group A,who were given a watchful waiting and served as control group.Group B received 2 mg tolterodine （twice a day）.Both groups were followed up 2 weeks.The stone expulsion rate and time and the number of pain episodes were obtained.Subjects rated the urgency associated with each micturition using the urinary sensation scale （USS）.Pain descriptions were recorded by the patients using the visual analogy scale （VAS）. Results： The stone expulsion rate in groups A and B was 56.4% and 57.0%,respectively（P〉0.99）.The mean numbers of renal colic episodes of patients in groups A and B had experienced 4.7 and 1.7,respectively.The USS for groups A and B in 3 and 7 days were 2.76±0.72,1.32±0.47,1.90±0.64,1.18±0.39,respectively（P〈0.001）.Statistically significant difference was found between groups A and B in relation to the VAS score on days 3 and 7,respectively（P〈0.001）. Conclusions： While our study demonstrated no improvement in expulsion rate,tolterodine reduced the common symptoms of frequency,urgency,intensity of the pain episodes and discomfort often associated with intramural ureter stone.

关 键 词：托特罗定 壁内段输尿管 结石 膀胱激惹症状 

分 类 号：R694.5[医药卫生—泌尿科学] R971.92[医药卫生—外科学]