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逼尿肌A型肉毒毒素注射联合前列腺等离子电切治疗膀胱出口梗阻伴膀胱活动过度患者的疗效分析

Therapeutic efficacy of detrusor injection of botulinum toxin type A combined with TURP in the treatment of bladder outlet obstruction and overactive bladder
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摘要 目的比较A型肉毒素膀胱逼尿肌注射联合前列腺等离子电切与单纯前列腺等离子电切治疗膀胱出口梗阻伴膀胱活动过度患者的疗效。方法回顾性分析2017年6月至2019年3月期间四川大学华西医院泌尿外科通过国际前列腺症状评分(IPSS)、膀胱过度活动症评分(OABSS)及尿动力学检查诊断为膀胱出口梗阻合并膀胱过度活动症患者45例,平均年龄(76±6.8)岁。其中逼尿肌A型肉毒毒素注射与前列腺等离子电切联合治疗组(联合治疗组,23例)与单纯前列腺等离子电切治疗组(单纯治疗组,22例)。比较两组术后膀胱冲洗袋数、术后3 d内膀胱痉挛次数、拔除尿管后第1天总排尿次数及术后最大尿流率、膀胱残余尿量等指标。结果在术后膀胱冲洗袋数、术后3 d内膀胱痉挛次数以及拔除尿管后第1天总排尿次数、尿急、尿失禁等方面,联合治疗组优于单纯治疗组,差异具有统计学意义(P<0.05)。而在术后最大尿流率、膀胱残余尿量上两组之间差异无统计学意义(P>0.05)。结论逼尿肌A型肉毒毒素注射联合前列腺等离子电切治疗膀胱出口梗阻伴膀胱活动过度安全有效,疗效优于单纯前列腺等离子电切。 Objective To compare the therapeutic efficacy of detrusor injection of botulinum toxin type A combined with transurethral resection of the prostate(TURP)and TURP alone in the treatment of bladder outlet obstruction and overactive bladder.Methods Clinical data of 45 patients with bladder outlet obstruction complicated with overactive bladder treated during June 2017 and March 2019 were retrospectively analyzed.The patients were confirmed by International Prostate Symptom Score(IPSS),Overactive Bladder Symptom Score(OABSS)and urodynamic testing preoperatively.The patients were divided into botulinum toxin type A plus TURP group(combined group,n=23)and TURP group(n=22).The number of postoperative bladder irrigation bags,number of cystospasms within 3 days after operation,number of urination on day 1 after catheter removal,maximum urine flow rate and postvoid residual volume were compared between the two groups.Results The combined group was superior to the TURP group in the number of bladder irrigation bags after surgery,number of cystospasms,and number of urination on day 1 after catheter removal(P<0.05).However,there were no significant differences in the maximum urine flow rate and postvoid residual volume between the two groups(P>0.05).Conclusion Detrusor injection of botulinum toxin type A combined with TURP is safe and more effective than TURP alone in the treatment of bladder outlet obstruction complicated with overactive bladder.
作者 张汉超 叶鑫 刘爽 邓钰涵 刘玲 ZHANG Han-chao;YE Xin;LIU Shuang;DENG Yu-han;LIU Ling(Department of Urology,Affiliated Hospital of Chengdu University,Chengdu 610081;Department of Urology,Institute of Urology,West China Hospital,Sichuan University,Chengdu 610041,China)
出处 《现代泌尿外科杂志》 CAS 2020年第10期898-901,共4页 Journal of Modern Urology
关键词 A型肉毒毒素 前列腺等离子电切 前列腺增生症 膀胱出口梗阻 膀胱过度活动症 botulinum toxin type A transurethral resection of the prostate benign prostate hyperplasia bladder outlet obstruction overactive bladder
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