女性糖尿病合并膀胱颈梗阻的诊断和治疗（附25例报道）.docVIP

· 1168 · 医学研究生学报2010年11月第23卷第11期J Med Postgra,Vol. 23,No. 11,November,2010 论 著 (临床研究) 女性糖尿病合并膀胱颈梗阻的 诊断和治疗(附25例报道) 丁留成，卫中庆，易超然，罗 锐，戴玉田，孙则禹 [摘要] 目的 糖尿病合并膀胱颈梗阻女性患者经尿道膀胱颈电切术后膀胱功能的恢复及症状的改善很不理想，给患 者带来极大的痛苦，文中探讨此类患者膀胱颈电切术后，应用溴吡斯的明联合盐酸阿夫唑嗪治疗的安全性及有效性。 方法 25例女性糖尿病合并膀胱颈梗阻患者，10例(A 组)膀胱颈电切术后予以口服盐酸阿夫唑嗪5mg(2 次/d);15 例(B 组)术后 予以口服盐酸阿夫唑嗪5mg(2 次/d),联合溴吡斯的明60mg(3 次/d)。 从排尿症状、尿动力学、B 超、膀胱镜检查结果多个角 度进行评估。 结果 2组术前指标比较无统计学差异，术后IPSS、残余尿、排尿量、最大尿流率几组参数较术前均有统计学 差异(P0.05), 术后3个月B 组患者排尿困难症状和生存质量明显改善，术后6个月，临床效果明显改善达76%(19/25)。 综合对比治疗后B 组患者IPSS、Qmax、Pdet,残余尿等指标较A 组更好，具有统计学差异(P0.05),2 组未观察到明显的毒副 作用。 结论 女性糖尿病合并膀胱颈梗阻患者膀胱颈电切术后，溴吡斯的明联合盐酸阿夫唑嗪是一种安全而有效治疗 选择。 [关键词] 女性膀胱颈梗阻；糖尿病；盐酸阿夫唑嗪；溴吡斯的明 [中图分类号] R694.2 [文献标志码] A [文章编号] 1008-8199(2010)11- 1168-04 Diagnosis and treatment of bladder neck obstruction in women with diabetes: A report of 25 cases DING Liu-cheng,WEI Zhong-qing2,YI Chao-ran,LUO Rui, DAI Yu-tian, SUN Ze-yu (1. Department of Urology, the Affiliated DrumTower Hospital of Nanjing University Medical School,Nanjing 211002,Jiangsu, China; 2. Department Of Urology, the second affiliated Hospital with Nanjing Medical Universi- ty,Nanjing 210011,Jiangsu,China) [Abstract ] Objective The effect of transurethral resection on the recovery of bladder function for the female diabetes patients with bladder neck obstruction is not ideal, which brings great pain to the patients. The effectiveness and safety of the combined therapy of pyridostigmine and alfuzosin hydrochloride after the treatment of transurethral resection of the bladder neck. Methods Total of 25 consecutive DM cases suffered from bladder neck obstruction were treated. After the resection of hinder margin on bladder neck,Inhibi- tor of receptor-al(alfuzosin hydrochloride 5mg,bid) were given in the 10 patients. Otherwise, the treatment group included 15 pa- tients who took alfuzosin hydrochloride(5mg,bid) and pyridostigmine(60mg. tid)in additi