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中华腔镜泌尿外科杂志(电子版)

中华腔镜泌尿外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (03) : 187 -190. doi: 10.3877/cma.j.issn.1674-3253.2019.03.011

所属专题： 文献；

临床研究

托特罗定联合坦索罗辛在改善输尿管支架管相关症状中的作用
屠卫超1, 潘隽玮1, 王大伟1, 陆国樑1, 高勤1, 邵远1,†()   
  1. 1. 201800　上海，交通大学医学院附属瑞金医院北院泌尿外科
  • 收稿日期:2018-06-13 出版日期:2019-06-01
  • 通信作者: 邵远

Effects of tolterodine combined tamsulosin on ureteral stent related symptoms

Weichao Tu1, Junwei Pan1, Dawei Wang1, Guoliang Lu1, Qin Gao1, Yuan Shao1,†()   

  1. 1. Department of Urology, Ruijin North Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201800, China
  • Received:2018-06-13 Published:2019-06-01
  • Corresponding author: Yuan Shao
  • About author:
    Corresponding author: Shao Yuan, Email:
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引用本文：

屠卫超, 潘隽玮, 王大伟, 陆国樑, 高勤, 邵远. 托特罗定联合坦索罗辛在改善输尿管支架管相关症状中的作用[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2019, 13(03): 187-190.

Weichao Tu, Junwei Pan, Dawei Wang, Guoliang Lu, Qin Gao, Yuan Shao. Effects of tolterodine combined tamsulosin on ureteral stent related symptoms[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2019, 13(03): 187-190.

目的

探讨托特罗定联合坦索罗辛在改善输尿管镜术后输尿管支架管相关症状中的作用。

方法

2017年11月到2018年4月，收集于本院行输尿管镜碎石取石术的患者，将符合入选标准的患者随机分为三组，组1接受坦索罗辛治疗，每日0.4 mg，于睡前一次口服；组2接受坦索罗辛联合托特罗定治疗，其中坦索罗辛每日0.4 mg，于睡前一次口服，托特罗定每日4 mg，分两次口服；组3为空白组。所有患者在术后第二天进行膀胱过度活动症患者自我评价量表（OABSS）评分及视觉模拟量表（VAS）评分后开始接受药物治疗，于术后4周拔管前再次进行OABSS评分及VAS评分并拔除双J管。

结果

共116例患者进入本研究，其中组1共39例，组2共39例，组3共38例。各组间药物治疗前各观察指标差异无统计学意义（P>0.05）。组1和组2于拔管前的OABSS评分和VAS评分较治疗前显著改善，OAB发生率显著减少（P<0.05）；组2的OABSS评分改善程度优于组1（P<0.05），而VAS评分改善程度与组1差异无统计学意义（P>0.05）。研究期间无明显药物不良反应。

结论

坦索罗辛联合托特罗定能有效改善支架管相关症状，改善储尿期症状效果优于单用坦索罗辛，且具有良好的安全性，但对腰痛症状改善与单用坦索罗辛相比无明显优势。

关键词: 坦索罗辛, 托特罗定, 支架管, 评分, 前瞻性
Objective

To evaluate the effects of Tolterodine and Tamsulosin in improving symptoms in patients with indwelling double-J ureteral stents.

Method

From Nov 2017 to Apr 2018, patients with insertion of a double-J ureteral stent (D-J stent) after ureteroscopy lithotripsy were prospectively randomized into three groups. Group 1 received Tamsulosin 0.4 mg per-night, Group 2 received Tamsulosin 0.4 mg per-night and Tolterodine 2 mg bid, Group 3 is the control group. All patients completed OABSS (Overactive Bladder Symptom Score) and VAS (visual analogue scale) scores the second day after the surgery, and again before D-J stent removal.

Result

A total of 116 patients were enrolled. 39 patients in group 1, 39 patients in group 2 and 38 patients in group 3. There was no statistically significant difference in background characteristics between the three groups. The most important and statistically significant results were Tolterodine combined Tamsulosin and Tamsulosin reduced OABSS and VAS. Scere Further. Tolterodine combined Tamsulosin reduced OABSS score more than Tamsulosin only. No side-effect was happened.

Conclusion

Tolterodine combined Tamsulosin can improve a subset of stent-related urinary symptoms and flank pain. The effect of relieve storage symptoms is better than that of tamsoloxine alone, and it has good safety. But the effect of relieve backache is similar with that of tamsoloxine alone.

Key words: Tamsulosin, Tolterodine, Double J stent, Score, Prospective
表1 三组放置输尿管支架管不同处置方法患者基线数据的比较
组别 性别（例） 年龄（岁，±s） 身高（cm，±s） 结石大小（mm，±s） OABSS评分（分，±s） 符合OAB诊断标准（例） VAS评分（分，±s）
男 女
组1 27 12 49±10 168±8 10.7±2.5 5.3±1.8 15 4.5±1.5
组2 25 14 49±11 169±7 9.9±1.9 5.5±1.3 16 4.8±1.4
组3 25 13 48±12 167±6 10.9±2.4 5.2±1.7 11 4.7±1.3
统计值 χ2=0.239 F=0.269 F=1.039 F=1.946 F=0.879 χ2=1.012 F=0.301
P值 0.888 0.764 0.357 0.148 0.418 0.603 0.741
表2 三组患者拔管前OABSS评分及VAS评分与基线比较
? OABSS评分（分，±s） 符合OAB诊断标准数（例） VAS评分（分，±s）
组1 组2 组3 组1 组2 组3 组1 组2 组3
基线 5.3±1.8 5.5±1.3 5.2±1.7 15 16 11 4.5±1.5 4.8±1.4 4.7±1.3
拔管前 3.5±1.8 3.0±1.2 5.1±1.7 07 04 13 3.8±1.3 3.8±1.2 4.5±1.4
统计值 t=5.322 t=8.958 t=0.941 χ2=4.052* χ2=9.683* χ2=2.244* t=3.173 t=6.488 t=1.845
P值 0 0 0.35 0.044* 0.002* 0.62* 0.003 0 0.073
表3 组1和组2间OABSS评分及VAS评分较基线改善值比较（分，±s）
组别 例数 OABSS评分 VAS评分
组1 39 1.5±1.8 0.7±1.4
组2 39 2.4±1.7 1.0±1.5
t值 ? -2.347 -0.926
P值 ? 0.022 0.357
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