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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蕈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(OABSS)、感知膀胱症状分级量表(PPBC)、生活质量评分(QOL)、患者OAB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(P<0.05)。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 investigate the efficacy and safety of high selective M receptor blocker in the treatment of overactive bladder (OAB) after transurethral prostatectomy (BIP). Methods: 102 cases of surgical patients were randomly divided into two groups, 51 cases in each group. The experimental group was treated with high selective M receptor blocker (Solifenacin Succinate), 2 ~ 3d preoperatively and 3 ~ 4 days postoperatively. Control group disabling interference detrusor muscle or muscarinic receptor antagonist and other drugs. The average number of urinary emergencies, the frequency of urination, the frequency of nocturnal urination, the number of urinary incontinence, bladder spasm, maximum blood flow rate (Qmax), residual urine volume (RUV) , International Prostate Symptom Score (IPSS), OABSS, PPBC, QOL, OAB symptom remission. Results: The number of urinary urgency, nocturnal urination, urinary incontinence, cystospasm, QOL score, IPSS score, PPBC score and OABSS score of experimental group were significantly lower than those of control group The difference was statistically significant (P <0.05). 24 h urinary catheter removal urinary number of experimental group, control group, no significant difference between groups was statistically significant. On the third day, the experimental group was lower than the control group, the difference between the two groups was statistically significant (P <0.05). There was no significant difference between the Qmax experimental group and the control group on the third day after catheter removal, while the RUV experimental group was significantly higher than the control group, the difference was statistically significant (P <0.05). The postoperative OAB group (9/51) and control group (19/51), the difference between the two groups was statistically significant (P <0.05). During the treatment, the incidence of adverse reactions in the experimental group was 15.7% (8/51). All patients were tolerated without serious adverse events. Conclusion: Perioperative application of high selective M receptor blocker in the prevention and treatment of overactive bladder after PKRP has definite curative effect, small complication and high safety. Clinical application is recommended.