储尿期症状明显的重度良性前列腺增生患者TURP术后M-受体阻滞剂用药方案探讨

发布时间：2018-05-19 20:48

  本文选题：良性前列腺增生 + 储尿期症状　； 参考：《中华男科学杂志》2017年09期

【摘要】：目的:探讨储尿期症状明显的重度良性前列腺增生(BPH)患者经尿道前列腺电切术(TURP)后口服M-受体阻滞剂的用药方案及其临床效果。方法:储尿期症状明显的重度BPH患者,TURP 6 h后开始口服酒石酸托特罗定片(2 mg每12 h 1次或4 mg 1次/d),4周后停药,如储尿期症状加重,继续服药2周再停药观察,如此反复直至术后12周。回顾性分析其术前,术后1、4、8、12周IPSS评分(总分、储尿期、排尿期症状评分)、QoL评分、Qmax和排尿后膀胱残余尿(PVR)。结果:临床资料完备病例共106例。其中4周停药后储尿期症状未加重(成功停药)者33例,6~8周成功停药者51例,10~12周成功停药者13例,12周后仍需继续服药者9例。术前,术后1、4、8、12周IPSS总分分别为(25.33±3.45)、(19.33±3.62)、(11.56±2.45)、(8.38±2.08)、(7.74±1.87)分;储尿期IPSS分别为(11.97±1.53)、(10.76±1.82)、(6.16±1.22)、(4.08±1.19)、(3.91±1.15)分;排尿期IPSS分别为(9.80±1.60)、(5.59±1.45)、(3.40±0.92)、(2.85±0.71)、(2.61±0.67)分;QoL评分为(4.70±0.78)、(3.92±0.75)、(2.55±0.74)、(1.83±0.72)、(1.66±0.75)分;除术后12周与术后8周比较外,术前、术后各观察点之间,IPSS各项指标均有显著性差异(P均0.01)。QoL、Qmax、PVR术后1、4周呈现进行性改善(P均0.01),4周后变化不再显著(P均0.05)。结论:储尿期症状明显的重度BPH患者TURP术后持续口服M-受体阻滞剂4~8周可能是治疗其术后储尿期症状的有效方案。
[Abstract]:Objective: to investigate the clinical effect of oral M- receptor blocker after transurethral resection of prostate (TURP) in patients with severe benign prostatic hyperplasia (BPH). Methods: the patients with severe BPH who had obvious symptoms in the period of urinary storage were treated with TURP 6 h later, and then they were given tolterodine tartrate 2 mg every 12 h or 4 mg / d after 4 weeks. If the symptoms in the period of urine storage became more serious, the patients should continue to take the drug for 2 weeks and then stop taking the drug for 2 weeks. It was repeated until 12 weeks after the operation. The preoperative and postoperative IPSS scores (total score, urine storage stage, urination symptom score, Qmax) and residual bladder urine (PVRV) after urination were analyzed retrospectively in 12 weeks (total score, urine storage stage, urination stage score, Qmax) and residual bladder urine after micturition (P < 0.05). Results: there were 106 cases with complete clinical data. Among them, 33 cases (successful withdrawal) after 4 weeks withdrawal of urine (successful withdrawal), 51 cases (51 / 10 / 12 weeks) successfully stopped the drug, 13 cases (13 / 12) still need to continue taking the drug after 12 weeks. 鏈�鍓�,鏈�鍚�1,4,8,12鍛↖PSS鎬诲垎鍒嗗埆涓，

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