托特罗定预防儿童膀胱造瘘术后膀胱痉挛临床研究  

Clinical efficacy and safety of tolterodine in the treatment of the children with bladder spasm after cystostomy

作　　者：刘奎[1] 李正伟[1] 张莹楠 李艺波 Liu Kui;Li Zhengwei;Zhang Yingnan(Department of Pediatric Surgery,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China)

机构地区：[1]河南科技大学第一附属医院小儿外科,河南洛阳471003

出　　处：《国际泌尿系统杂志》2018年第4期589-592,共4页International Journal of Urology and Nephrology

摘　　要：目的 探讨托特罗定在预防治疗儿童膀胱痉挛中的应用价值.方法 60例行耻骨上膀胱造瘘患儿随机分为两组,托特罗定组32例,给予托特罗定2 mg,每日2次;普鲁本辛组28例,给予普鲁本辛2 mg·（kg·d）^-1,每日2次,术后6h开始分别给药.记录术后t1～ t4[t1（术后～术后6h）,t2（术后6 h～术后24h）,t3（术后24 h～术后48 h）,t4（术后48 h～术后72h）]不同时段患儿膀胱痉挛的发生次数,疼痛程度VAS评分以及药物不良反应发生率.结果 两组患儿术后t1内发生膀胱痉挛次数差异无统计学意义（P＞0.05）;口服托特罗定组患儿在术后t2～t4时段内膀胱痉挛的发生次数明显少于口服普鲁本辛组（P＜0.01）;两组患儿膀胱痉挛发生次数最多的时段为术后t2和t3.膀胱痉挛发生时托特罗定组患儿VAS评分明显小于普鲁本辛组（P＜0.01）.口服托特罗定组患儿口干、面红、便秘的发生率低于口服普鲁本辛组（P＜0.05）.结论 与普鲁本辛相比,口服托特罗定能减少膀胱造瘘术后膀胱痉挛发生次数以及减轻患儿痉挛症状,口干、面红等不良反应发生率低.在儿童膀胱痉挛的治疗中安全有效.Objective To evaluate the efficacy and safety of tolterodine in children with bladder spasm after cystostomy.Methods A total of 60 children between 5 and 12 years old operated by cystostomy were enrolled.Thirty-two children received tolterodine （trail group,2 mg twice daily）,28 children received propantheline bromide [control group,2 mg · （kg · d）^-1,twice daily].Drugs were dispensed to children firstly 6 hours later after operations.The frequency and degree of bladder spasm in different periods of each child after cystostomy were recorded.Spasm pain was assessed using Visual Analog Scale （VAS,0 =no pain,10 =pain as bad as it cloud possibly be）.Results The frequency of bladder spasm in tolterodine group （T group） was no different with that in propantheline bromide （P group） during t1 （operation-6 h after operation） （P 〉0.05）.The bladder spasm episodes in T group during t2,t3 and t4 （6 ～48 h after operation） were significantly lower than those in P group （P 〈0.01）.The highest bladder spasm episodes were during t2 and t3 （6 ～24 h after operation） in both groups （P 〈0.01）.VAS score was significantly lower in T group than that in P group when bladder spasm occurred （P 〈 0.01）.However VAS score was no significandy in T group and in P group when bladder spasm not occurred （P 〉0.05）.The incidence of side effects such as dry mouth,flushing and constipation were significantly lower in T group than those in P group.Conclusions Tolterodine can effectively reduce the number of bladder spasm attack and relieve the pain symptom after cystostomy.It also has a lower incidence of side effects such as dry mouth,flushing and constipation.Tolterodine may be safety and effective to bladder spasm in children.

关 键 词：膀胱造口术 痉挛 手术后并发症 

分 类 号：R726.9[医药卫生—儿科]