联合应用坦素罗辛与溴吡斯的明治疗宫颈癌术后尿潴留

The treatment of urinary retention after radical hysterectomy with tamsulosing combining pyridostigmine bromide

目的分析盐酸坦素罗辛联合溴吡斯的明防治宫颈癌行广泛性子宫切除术后尿潴留的疗效。方法自1999年3月至2007年4月在复旦大学附属中山医院因宫颈癌行广泛性子宫切除术的患者57例,治疗组28例,为拔导尿管前后口服盐酸坦素罗辛和溴吡斯的明的患者;对照组29例,为单纯导尿的患者。两组手术范围、术中出血、年龄等情况大致相当。比较两组尿潴留发生情况及药物毒副反应。结果在经术后常规导尿1周或2周,治疗组和对照组发生尿潴留者分别为3例(10.7%)与17例(58.6%),尿潴留发生率前者显著低于后者(P<0.01)。首次拔管后治疗组平均膀胱残余尿量为(44.4±60.9)mL,对照组为(167.8±159.9)mL,前者显著低于后者(P<0.01)。分层数据显示,无论术后1周还是2周拔除导尿管,治疗组的膀胱残余尿均显著少于对照组(P<0.05)。治疗组未观察到明显的毒副作用。结论盐酸坦素罗辛联合溴吡斯的明对防治宫颈癌广泛性子宫切除术后的尿潴留有较好的作用,可在临床推广应用。

Objective To determine whether tarnsulosing hydrochloride combined with pyridostigmine bromide would be a feasible method for the treatment of postoperative urinary retention in patients with cervical cancer. Methods A total of hysterectomy in our department from Mar. 1999 to 57 patients with cervical cancer underwent radical Apr. 2007. The control group included 29 patients who were treated only with urethral catheterization. The treatment group included 28 patients who took orally tamsulosing and pyridostigmine bromide in addition to urethral catheterization. The charac- teristics of the two groups, such as operation range, amount of hemorrhage during operation, and age, were comparable. The value and adverse effects of treatment to postoperative urinary retention were analyzed. Results Through a routine urethral catheterization for 1 or 2 weeks, the patients suffering from urinary retention in treatment group and control group were 3 cases （10. 7%） and 17 cases （58. 6%）, respectively. The former was significantly lower than the latter （P〈 0. 01 ）. After first extubation, the average volume of bladder residual urine was （44. 4 ± 60. 9） mL in treatment group, and （167.8 ± 159. 9） mL in control group. The former was significantly lower than the latter （P〈0. 01）. The stratification data showed similar results no matter performing extubation in one week post-operation or two weeks. No severe adverse effect was observed in the treatment group. Condusions Tamsulosing hydrochloride combined with pyridostigmine bromide has obvious effect to treat postoperative urinary retention. This therapy can be extended to clinic widely.