米拉贝隆对比索利那新在治疗经尿道前列腺汽化电切术后膀胱痉挛的临床研究  

Mirabelon vs.solifenacin in the treatment of bladder spasm after transurethral vaporized electrotomy of prostate

作　　者：顾朝辉[1] 罗洋 袁瑞 王一地 于顺利 邢会武 冯勇杰 陈龙[1] 樊瑞新 窦晨阳 Gu Chaohui;Luo Yang;Yuan Rui;Wang Yidi;Yu Shunli;Xing Huiwu;Feng Yongjie;Chen Long;Fan Ruixin;Dou Chenyang(Department of Urology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院泌尿外科,450052

出　　处：《中华实验外科杂志》2020年第4期748-753,共6页Chinese Journal of Experimental Surgery

摘　　要：目的探讨比较米拉贝隆、索利那新单药治疗及联合治疗经尿道前列腺汽化电切(TUVEP)术后膀胱痉挛的有效性及安全性。方法 2018年9月至2019年12月,采用前瞻性随机病例对照的方法,将郑州大学第一附属医院泌尿外科80例TUVEP术后患者纳入本研究。采用抽签随机分组的方式将患者随机分为4组,每组20例,分别为索利那新组、米拉贝隆组、双药组、对照组。记录患者术后7 d内膀胱痉挛的客观指标(痉挛次数、痉挛持续时间)及主观评测表格[视觉模拟评分法(VAS)、排尿相关的生活质量评分表(QOL)及膀胱状态感知分级量表(PPBC)],同时记录服药期间出现的相关不良反应。组间及组内数据均数的多重两两比较采用基于方差分析的Dunnett-t检验。结果在所有观察项目中,索利那新组对比米拉贝隆组差异均无统计学意义(t=0.147、0.442、0.834、1.026、1.173,P>0.05);在痉挛次数[(0.88±0.74)次比(1.37±0.91)、(1.38±0.84)、(3.01±1.39)次]、持续时间[(21.79±19.00) min比(38.65±26.45)、(34.71±23.36)、(90.71±43.07) min]、VAS评分[(2.70±1.09)分比(3.23±1.51)、(3.22±1.42)、(5.34±1.42)分]及PPBC量表[(1.89±0.68)分比(2.52±0.70)、(2.45±0.60)、(3.55±0.89)分]方面,双药组对比其余3组有明显的优势,对照组对比其余3组劣势明显,其差异有统计学意义(t=4.482、4.677、3.571、3.134、4.579、3.782、2.968、4.427,P<0.05);在QOL评分方面,索利那新组、米拉贝隆和双药组三者比较差异无统计学意义(t=1.173,P>0.05),相反的是,其3组对比对照组均有优势,其差异均有统计学意义(t=4.158,P<0.05);以术后天数为变量因子的亚组分析中,在痉挛次数、持续时间、VAS评分方面,术后第6~7天,索利那新组、米拉贝隆组和双药组之间差异无统计学意义(t=0.086、0.102、1.837,P>0.05);在痉挛次数、持续时间方面,术后第7天,4个观察组之间差异均无统计学意义(t=0.021、0.136,P>0.05)。本研究中�Objective To evaluate the efficacy and safety of mirabegron,solifenacin and combination therapy for bladder spasm after transurethral vaporized electrotomy of prostate(TUVEP).Methods From June 2018 to June 2019,80 cases of TUVEP patients in Urology Department of the First Affiliated Hospital of Zhengzhou University were included in this study by single blind randomized method.Patients were divided into four groups according to the different drugs taken after surgery:solifenacin group,mirabegron group,dual-drug group,control group,n=20 each.Objective indicators of bladder spasm(frequency and duration of spasm)and subjective evaluation tables[visual analogue pain scale(VAS),quality of life(QOL),patient perception of bladder condition(PPBC)]were recorded within 7 days after the operation.Meanwhile,relevant adverse reactions during medication were recorded.Results In all observation items,there was no statistically significant difference between the solifenacin group and mirabegron group(t=0.147,0.442,0.834,1.026,1.173,P>0.05).In terms of spasm frequency[(0.88±0.74)times vs.(1.37±0.91),(1.38±0.84),(3.01±1.39)times],duration[(21.79±19.00)min vs.(38.65±26.45),(34.71±23.36),(90.71±43.07)min],VAS score(2.70±1.09 vs.3.23±1.51,3.22±1.42,5.34±1.42)and PPBC scale(1.89±0.68 vs.2.52±0.70,2.45±0.60,3.55±0.89),as compared with the other three groups,the double-drug group had obvious advantages and the difference was statistically significant,while the control group had obvious disadvantages and the difference was statistically significant(t=4.482,4.677,3.571,3.134,4.579,3.782,2.968,4.427,P<0.05).In terms of QOL score,there was no statistically significant difference among solifenacin group,mirabegron group and dual-drug group(t=1.173,P>0.05),but there was statistically significant difference in solifenacin group,mirabegron group and dual-drug group from the control group(t=4.158,P<0.05).In the subgroup analysis with the number of days after surgery as a variable factor,in terms of the number of spasms,duration an

关 键 词：索利那新 米拉贝隆 经尿道前列腺汽化电切 膀胱痉挛 

分 类 号：R699.8[医药卫生—泌尿科学]