【摘 要】 目的：探讨术前联合应用盐酸坦索罗辛缓释胶囊和托特罗定治疗经皮肾镜取石术(PCN)留置双J管致术后膀胱过度活动(OAB)的效果。方法：对116例PCN患者随机分为2组，A组59例，术前2天给予盐酸坦索罗辛缓释胶囊0.2mg口服qd，酒石酸托特罗定缓释胶囊4mg口服qd至术后拔除双J管。B组57例，术后给予坦索罗辛缓释胶囊及托特罗定至术后1周。结果：A组术后OAB发生率 71.19%，症状评分1.68±0.48，B组术后OAB发生率 89.47%，症状评分2.01±0.49，两组有显著差异。结论：联合应用盐酸坦索罗辛缓释胶囊、托特罗定能够有效缓解PCN术后留置双J管导致的膀胱过度活动，减少尿液反流引起的腰部不适，减轻病人痛苦。

【关键词】 经皮肾镜取石术;膀胱过度活动;疗效观察

【中图分类号】R198 【文献标识码】A 【文章编号】1004-7484(2019)06-0112-02

Observation of effectiveness of patients with overactive bladder because of

D-J after PCN treated by Tamsulosin Hydrochloride and Tolterodine preoperative. Wang Jinshan，Liu Qinghong，Wang Tiejun. Department of Urology， East Hospital， Tongji University School of Medicine， Shanghai， China 200123

【Abstract】 Objective To investigate the clinical effect of patients with overactive bladder (OAB) because of D-J after PCN treated by Tamsulosin Hydrochloride combined with Tolterodine preoperative.Methods 116 patients were randomly divided into two groups，59 patients in group A were treated by Tamsulosin Hydrochloride combined with Tolterodine from 2 days preoperative to the D-J pulled out，57 patients in group B were treated by Tolterodine combined with Terazosin 7 days afteroperation. Results The incidence rate was 71.19% in group A and 89.49% in group B.The symptom score was 1.68±0.48 in group A and 2.01±0.49 in group B. Conclusions It is exactly more effective in prevention of patients with D-J caused OAB after PCN treated by Tamsulosin Hydrochloride combined with Tolterodine preoperative.

【Key words】 PCN; overactive bladder; observation of effectiveness

    經皮肾镜取石术后一般留置D-J管2～4周，位于膀胱内的D-J管末端刺激可引起膀胱过度活动。根据国际尿控协会(International continence society，ICS)的定义，膀胱过度活动(overactive bladder，OAB)是指以尿急为主要症状，伴或不伴急迫性尿失禁、胱区疼痛不适等。同时因留置D-J管，OAB发生时可引起膀胱输尿管反流，出现患侧腰部酸胀或疼痛不适。我们自2017年1月～2019年1月，对输尿管结石术后留置D-J管的患者给予α受体阻滞剂盐酸坦索罗辛缓释胶囊联合M受体阻滞剂托特罗定口服，缓解术后OAB及患者腰部不适，取得满意效果，现报告如下。

    1材料与方法

    1.1 一般资料

    116例均为我科经皮肾镜取石手术的患者，年龄16～89岁，平均49.3岁。男75例，女41例，其左肾结石51例，右肾结石39，左侧输尿管上段结石9例，右侧输尿管上段结石7例，双肾结石10例。均采取经皮肾镜钬激光碎石取石手术，所有患者均于术中留置D-J管。按入院时间分为A、B两组，A组59例，B组57例。两组间患者的性别、年龄、术后留置D-J管时间等均无显著差异。(王金善 刘庆红 王铁军 张文元 赵俊)