文章摘要
李建章 刘景隆 郭宇 沙江 李庆.A 型肉毒素膀胱内阻滞治疗女性膀胱过度活动症的临床效果观察[J].,2014,14(1):163-165
A 型肉毒素膀胱内阻滞治疗女性膀胱过度活动症的临床效果观察
Observation on the Efficacy of Block in the Bladder by Trebotulinumtoxin-A in the Treatment of Female Overactive Bladder
  
DOI:
中文关键词: 膀胱过度活动症  A 型肉毒毒素  酒石酸托特罗定
英文关键词: Overactive bladder  Botulinumtoxin type A  Tolterodine tartrate in Luoding
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作者单位
李建章 刘景隆 郭宇 沙江 李庆 哈尔滨医科大学附属第四医院泌尿外科黑龙江省康复医院(黑龙江省第五医院)神经康复科黑龙江省康复医院(黑龙江省第五医院)神经一病房嫩江县人民医院泌尿外科 
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中文摘要:
      目的:探讨A 型肉毒素膀胱内阻滞治疗女性膀胱过度活动症的临床效果。方法:选择2010 年10 月至2012 年10 月,哈尔滨 医科大学附属第四医院泌尿外科收治的女性膀胱过度活动症患者24 例,随机分为治疗组和对照组,治疗组(A 组)选用国产A 型 肉毒素(衡力)100 IU 治疗,用10 mL 生理盐水稀释后,通过膀胱镜进行壁内注射;对照组(B 组)患者给予口服经典的抗胆碱制剂, 酒石酸托特罗定片,每天口服2 次,每次2 mg,疗程不少于6 周。于治疗前,治疗后1 周和4 周观察和比较两组患者的IPSS评分、 初尿意膀胱容量、最大膀胱容量。结果:与治疗前比较,A 组治疗后1 周,IPSS评分显著下降(P<0.05),初尿意膀胱容量及最大膀胱 容量显著上升(P<0.05),治疗后第2 周和第4 周均维持在相当水平,残余尿量第1 周未见明显下降(P>0.05),第4 周时与基线比较 下降明显(P<0.05);B组于治疗后第4 周时,以上三项指标与治疗前比较才有统计学差异(P<0.05),残余尿量在第1 周即有明显下 降(P<0.05),并且第4 周时仍维持第1 周水平(P>0.05)。此外,治疗后第1 周两组比较以上指标比较有统计学差异(P<0.05),而治疗 后第4 周无明显差异(P>0.05)。结论:经尿道膀胱壁内肉毒素A 注射和口服酒石酸托特罗定均是治疗女性膀胱过度活动症的有效 方法,但A 型肉毒素膀胱内注射起效更快,同时由于其接触性和直观性,疗效更确切。
英文摘要:
      Objective: To investigate the clinical effect of bladder block relieved by botulinum toxin-A on the female overactive bladder. Methods: From Oct 2010 to Oct 2012, 24 female patients with overactive bladder in the Department of Urology, the fourth affiliated of Harbin Medical University were chosen and randomly assigned to trebotulinum toxin-A (Hengli) in their wall of urinary bladder(A group). 100 IU botulinumtoxin-A was diluted in 10ml physiologic saline. The control group(B group) was asked to take orally tartaric acid Tolteroine stator twice everyday, 2 mg every time, lasting more than 6 weeks. It was requested to record patients' I-PSS, initial micturition desire bladder capacity, maximum bladder capacity in the pre-therapy and the 1st week, 4th week, 6th week of post-therapy. The data was analyzed with the application of the SPSS12.0 statistic software.Results: Compared with the pre-therapy, the IPPS score of A group was decreased significantly (P<0.05), the increment of initial micturition desire bladder capacity(P<0.05)and maximum bladder capacity (P<0.05) were both increased markedly after 1 week treatment, which maintained the equal level in the 2nd weeks and 4th week, no significant difference of residual urine volume was found in the 1st week, which was significantly decreased in the 4th week (P<0.05). In regard to the control group, these 3 indexes showed differences in the 4th week compared with pre-therapy (P<0.05), the residual urine volume was significantly decreased in the 1st week(P<0.05) and maintained the equal level until the 4th week (P>0.05). Moreover, The index mentioned above showed significant difference in the 1st week between 2 groups (P<0.05), but no significant difference was found in the 4th week between 2 groups (P>0.05).Conclusion: The results presented that these were effective methods of botulinum toxin-A (Hengli) in their wall of urinary bladder and oral tartaric acid Tolteroine stator in the treatment of female overactive bladder. Further, it is faster in the method of botulinum toxin-A (Hengli) in their wall of urinary bladder. Besides, the method has an advantage of more accurate curative effect due to contact and intuitive features.
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