PKRP围手术期应用高选择性M受体阻滞剂防治术后膀胱过度活动症  

Clinical research of high-selected M-receptor blocker in the treatment of overactive bladder during the perioperative period of PKRP

作　　者：李飞[1] 李鹏程[2] 吴越[3] 张国飞[3] 邓玮[3] 陈安龙[3] 孙研[3] 闫振[3] 

机构地区：[1]新疆医科大学研究生院,乌鲁木齐830000 [2]桂林医学院研究生院 [3]新疆医科大学第六附属医院泌尿外科

出　　处：《临床泌尿外科杂志》2014年第4期313-315,318,共4页Journal of Clinical Urology

基　　金：新疆维吾尔自治区高技术研究发展项目基金(编号201110108)

摘　　要：目的：探讨高选择性M受体阻滞剂防治经尿道前列腺等离子体双极电切术（PKRP）术后膀胱过度活动症（OAB）的疗效及安全性。方法：102例手术患者随机分为2组，每组51例。实验组应用高选择性M受体阻滞剂（琥珀酸索利那新）治疗，术前2～3d，术后3～4d给药。对照组禁用干扰膀胱逼尿肌或毒草碱受体拮抗剂等药物。观察比较2组患者拔出导尿管后24h、3d平均每天尿急次数、排尿次数、夜尿次数及急迫性尿失禁次数、膀胱痉挛、最大尿流率（Qmax）、剩余尿量（RUV）、国际前列腺症状评分（IPSS）、膀胱过度活动症评分（OAB—SS）、感知膀胱症状分级量表（PPBC）、生活质量评分（QOL）、患者0AB症状缓解率。结果：实验组拔除尿管后24h、3d的每天的尿急次数、夜尿次数、急迫性尿失禁次数、膀胱痉挛、QOL评分、IPSS评分、PPBC评分、OABSS评分均低于对照组，组间比较差异有统计学意义（P〈0．05）。拔除导尿管后24h排尿次数实验组、对照组，组间比较差异无统计学意义。而第3天实验组低于对照组，组间比较差异有统计学意义（PG0．05）。拔除导尿管第3天的Qmax实验组、对照组组间比较差异无统计学意义；而RUV实验组明显高于对照组，组间比较差异有统计学意义（P〈0．05）。术后OAB症实验组（9／51）、对照组（19／51），组间比较差异有统计学意义（P〈0．05）。治疗期间实验组不良反应发生率为15．7％（8／51），患者均可耐受，未发生严重不良事件。结论：PKRP围手术期应用高选择性M受体阻滞剂防治术后膀胱过度活动症疗效确切，并发症小，安全性高，可推荐临床使用。Objective： To evaluate the efficacy and safety of high-selected M-receptor blocker in the prevention and treatment of overactive bladder （OAB） in patients underwent transurethral bipolar plasmakinetic resection of prostate （PKRP）. Method： One hundred and two cases underwent bipolar plasmakinetie resection of prostate were randomly divided into two groups. Each group had 51 cases. Th.e patients of experimental group received high-se- lected M-receptor blocker （solifenacin succinate） treatment two to three days preoperatively and three to four days postoperatively. The patients of control group did not take any drugs interfering with bladder detrusor. We ob- served and compared the data of two groups of patients after catheter removed including the mean times of urgency episodes, micturition, nocturia, urinary incontinence and other records such as bladder spasms, Q residual u- rine volume （RUV）, International Prostate Symptom Score （IPSS）, overactive bladder symptom score （OABSS）, Patient Perception of Bladder Condition （PPBC）, quality of life （QOL） and OAB remission rate were analyzed. Result： It was found that on the first and third days after catheter removal the incidence of urinary urgency, noctu- ria, urge incontinence frequency, bladder spasms, QOL score, IPSS, PPBC score, OABSS of the experimental group were lower than the control group （ P 〈0.05）. There were significant differences between two groups. However, 2 4 hours after removal of the catheter , times of micturition in experimental group and control groupshowed no significant difference, while on the third days the difference between experimental group and control group was found significant （ P 〈0.05）. Three days after removal of the catheter Q max of experimental group and control group revealed no significant difference. But RUV of experimental group was significantly higher than the control group. There was significant difference between two groups in overactive bladder remission rate （ P 0.05�

关 键 词：高选择性M受体阻滞剂 等离子体双极电切术 膀胱过度活动症 

分 类 号：R697.3[医药卫生—泌尿科学]