索利那新联合透明质酸钠膀胱灌注对重度女性膀胱过度活动症的治疗效果

Analysis the effect of solifenacin combined with sodium hyaluronate intravesical instillation in treating female patients with severe overactive bladder

目的探讨索利那新联合透明质酸钠膀胱灌注对治疗重度女性膀胱过度活动症(OAB)患者的有效性及安全性。方法回顾性分析2014年1月至2017年6月就诊于中国医科大学附属盛京医院妇科盆底门诊的重度OAB、每日口服索利那新10 mg、至少2周无明显效果的78例患者的临床资料,依照治疗方法分为对照组(继续按原剂量口服琥珀酸索利那新片8周,30例)和研究组(继续按原剂量口服索利那新的基础上加每周膀胱灌注透明质酸钠一次,48例)。所有患者均进行OAB症状评分(OABSS)及记录排尿日记。分别对治疗后2个月、6个月及12个月的OABSS评分进行比较。结果研究组治疗前、治疗后2个月、6个月和12个月OABSS总评分分别为(12.88±0.89)分、(5.73±1.32)分、(9.15±1.58)分和(11.79±1.25)分;对照组分别为(12.77±0.73)分、(7.23±1.89)分、(11.63±1.33)分和(12.60±0.62)分;研究组患者治疗后各时间点OABSS总分与治疗前比较,差异均有统计学意义(P <0.05),而对照组患者治疗后2个月、6个月的OABSS总分与治疗前比较,差异有统计学意义(P <0.05),但治疗后12个月的OABSS总分与治疗前比较,差异无统计学意义(P>0.05)。两组患者治疗前OABSS总分比较,差异无统计学意义(P>0.05),治疗后各时间点OABSS总分比较,差异有统计学意义(P <0.05)。研究组患者中,9例出现口干、便秘等不良反应,无血尿等与膀胱灌注相关的副反应;对照组患者中,6例出现口干、便秘等不良反应。结论口服索利那新与膀胱灌注透明质酸钠在短期内可明显改善重度膀胱过度活动症患者的生活质量,且副作用小。

Objective To explore the effect and safety of solifenacin combined with sodium hyaluronate intravesical instillation compared to only solifenacin in the treatment of female patients with severe overactive bladder(OAB).Methods Selecting a total of 78 female patients diagnosed as severe OAB in China Medical University Affiliated Shengjing Hospital gynecological pelvic floor outpatient from Janary.2014 to July.2017,who have taken solifenacin reaching the maximum dose,but OABSS scores had no change.In 78 cases,48 cases continued to take solifenacin with the maximum dose,at the same time,sodium hyaluronate intravesical instillation once a week(treatment group).Another 30 cases only continued to take solifenacin with the maximum dose(control group).We collected data through the questionnaire(OABSS) and voiding diary recorded by patients themselves before and after the treatment.Results In treatment group,the OABSS scores before and after treatment in 2 month,6 month and one year were 12.88±0.89,5.73±1.32,9.15±1.58,11.79±1.25,respectively.In control group,OABSS scores before and after treatment in 2 month,6 month and one year were 12.77±0.73,7.23±1.89,11.63±1.33 and 12.60±0.62,respectively.The total score of OABSS at each time point after treatment in the treatment group was statistically signif icant compared with that before treatment(P <0.05).The OABSS scores of the control group at 2 month and 6 month after treatment were statistically signif icant(P <0.05),but the OABSS scores of one year after treatment were not statistically signif icant(P >0.05).There was no statistically signif icant difference(P >0.05) in the total score of OABSS before treatment between two groups,but there was statistically signif icant difference(P <0.05) in the total score of OABSS at each time point after treatment.There were 9 cases of adverse reactions such as dry mouth and constipation,and no side effect associated with intravesical instillation such as hematuria in treatment group,while there were 6 cases of adverse reactions such as dry mouth and constipation in control group.Conclusion Oral solifenacin combined with sodium hyaluronate intravesical instillation can signif icantly improve the quality of life in patients with severe overactive bladder in the short term with few side effects.