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

在线阅读下载PDF

收藏分享导出

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)

机构地区成都大学附属医院泌尿外科四川大学华西医院泌尿外科

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

分类号 R694 [医药卫生—泌尿科学]

引文网络
相关文献

参考文献2

1孙自学,宋春生,邢俊平,毛向明,李湛民,郝高利,.良性前列腺增生中西医结合诊疗指南（试行版）[J].中华男科学杂志,2017,23(3):280-285. 被引量：116
2肖河,李汉忠,杨勇,黄钟明,李永强,赵晓峰.M-受体与α-受体阻滞剂联合用药治疗良性前列腺增生及下尿路症状的临床观察[J].中华医学杂志,2007,87(23):1590-1593. 被引量：5

二级参考文献26

1范洪力.良性前列腺增生症证候临床研究[J].中国医药指南,2008,0(23):401-402. 被引量：7
2张亚大 ,卢子杰 ,顾晓箭 ,张平 ,徐彦 ,黄树纲 .500例良性前列腺增生症中医证型与临床相关因素分析[J].南京中医药大学学报,2004,20(5):281-283. 被引量：9
3阙艳红,王学梅.双平面经直肠超声诊断良性前列腺增生的探讨[J].中华男科学杂志,2005,11(3):191-194. 被引量：12
4杜元灏,李晶,孙冬纬,刘维红,李桂平,林雪,任辉,王涵,邹蓓蕾,焦素林,黄卫.中国现代针灸病谱的研究[J].中国针灸,2007,27(5):373-378. 被引量：204
5Peters, TJ, Donovan JL, Kay HE, et al. The international continence society " benign prostatic hyperplasia " study: the bothersomeness of urinary symptoms. J Urol, 1997,157:885. 被引量：1
6Roiser PF, de la Rosette J J, Wijkstra H, et al. Is detrusor instsbility in elderly males related to the grade of obstruction? Neurourol Uredyn, 1995,14:625. 被引量：1
7Crawford ED. Management of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: the central role of the patient risk profile. BJU International ,2005,95 (suppl 4) :1-5. 被引量：1
8Park CH, Chang HS, Oh BR, et al. Efficacy of low-dose tamsulosin on lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Clin Drug Invest, 2004,24:41-47. 被引量：1
9Lee KS, Choo MS, Kim DY, et al. Combination treatment with propivefine hydrochlofide plus doxazosin controlled release gastrointestinal therapeutic system formulation for overactive bladder and coexisting benign prostatic obstruction : a prospective, randomized, controlled multicenter study. J Urol, 2005,174:1334- 1338. 被引量：1
10Athanasopoulos A, Gyftopoulos K, Giannitsas K, et al. Combination treatment with an -blocker plus an anticholinergic for bladder outlet obstruction: a prospective, randomized, controlled study. Int Journal Urology, 2003,169:2253-2256. 被引量：1