M受体阻滞剂联合α受体阻滞剂治疗留置双J管患者下尿路症状的疗效观察  

Evaluation of combination therapy with M and α receptors antagonist for the treatment of double-J stent related lower urinary tract symptoms

作　　者：赵伊立 孙发[1] 孙超[1] 石家齐[1] 陈方敏[1] 谷江[1] 唐开发[1] 

机构地区：[1]贵阳医学院附属医院泌尿外科,550004

出　　处：《中华泌尿外科杂志》2015年第5期376-379,共4页Chinese Journal of Urology

基　　金：国家自然科学基金（81300541）;贵州省科学技术基金计划项目[黔科合J字（2013）2051号];贵阳医学院附属医院博士基金（C-2012-6）

摘　　要：目的 探讨M受体阻滞剂联合α受体阻滞剂治疗留置双J管患者的下尿路症状（LUTS）的疗效.方法 回顾性分析2013年5月至2014年5月131例输尿管镜碎石术、腹腔镜下输尿管切开取石术及肾盂成形术后留置双J管患者的临床资料.男71例,女60例.年龄29～ 64岁,平均（47.4±15.2）岁.采用就诊顺序计算机随机数法分为4组：A组30例,未服用任何药物;B组34例,服用坦索罗辛0.2 mg,1次/d;C组32例,服用索利那新5.0 mg,1次/d;D组35例,服用坦索罗辛0.2 mg＋索利那新5.0 mg,1次/d.A、B、C、D组术前国际前列腺症状评分（IPSS）分别为9.01 ±2.79、7.89±4.29、7.94±4.27、8.21 ±3.18,生命质量评分（QOL）分别为：2.53±1.86、2.49±2.18、2.51±1.94、2.52±2.10;可视疼痛量表评分（visual analogue pain scale,VAPS）分别为6.21±1.78、6.34±1.95、6.47±1.90、6.30±1.49.术后1、4周复查4组患者的IPSS、QOL、VAPS,并与术前数据进行比较.结果 A、B、C、D组术后1、4周IPSS分别为13.18 ±3.79和13.79±3.76、12.39±3.90和12.21±3.87、12.70±4.01和11.98±4.69、11.97±5.03和8.17±3.25,与术前比较差异均有统计学意义（P＜0.05）;术后1、4周A、B、C组分别与D组比较差异有统计学意义（P＜0.05）.术后1周QOL各组间比较差异无统计学意义（P＞0.05）;术后4周QOL,D组（1.53±1.42）显著分别低于A（2.85±2.12）、B（2.65±2.20）、C组（2.72±2.41）,差异有统计学意义（P＜0.05）.术后1、4周VAPS评分4组间比较差异无统计学意义（P＞0.05）.结论 M受体阻滞剂联合α受体阻滞剂可显著改善留置双J管引起的LUTS.Objective To evaluate the efficacy of combination therapy with M and α receptors antagonist for the treatment of double-J stent related lower urinary tract symptoms.Methods From May 2013 to May 2014,131 cases,including 71 male and 60 female cases,were accepted the doubte-J stent indwelling after the ureteral lithotripsy,laparoscopic ureterlithotomy and pyeloureteroplasty.Their data was retrospectively reviewed.The age ranged from 29 to 64 years old,mean （47.4 ± 15.2） years old.They were divided into 4 groups randomly,including group A （control group,n =30）,no drugs were taken;group B （tamsulosin group,n =34）,0.2 mg tamsulosin was taken qd;group C （solifenacin group,n =32）,5 mg solifenacin was taken qd;group D （tamsulosin combined with solifenacin group,n =35）,0.2 mg tamsulosin and 5mg solifenacin were taken qd.The IPSS scores,QOL scores and visual analogue pain scale （VAPS） scores were assessed pre-operation,1 week after operation,and 4 weeks after operation,respectively.Results All patients were followed-up until the end of this study.In each time point,the IPSS scores in group A was 9.01 ± 2.79,13.18 ± 3.79 and 13.79 ± 3.76,respectively.In group B,the IPSS scores were 7.89 ± 4.29,12.39 ±3.90 and 12.21 ±3.87,respectively.In group C,the IPSS scores were 7.94 ±4.27,12.70 ±4.01 and 11.98 ±4.69,respectively.In group D,the IPSS scores were 8.21 ±3.18,11.97 ±5.03 and 8.17 ± 3.25,respectively.Significant difference in total IPSS scores and obstruction symptom scores were shown between pre-and post-operation （P 〈 0.05）.Comparing to other groups,group D exhibited the significant improvement in IPSS scores 1 and 4 weeks after the operation （P 〈0.05）.4 weeks after operation,the QOL scores in group D was significantly lower than that in other groups （P 〈 0.05）.While the VAPS scores didn t show significant differences among those groups （P 〉 0.05）.Conclusion M and α receptors antagonist combination therapy can significantly improve lower urinary tract symptom due

关 键 词：索利那新 坦索罗辛 双J管 下尿路症状 

分 类 号：R699[医药卫生—泌尿科学]