溴吡斯的明联合坦索罗辛治疗良性前列腺增生伴急性脑梗死后尿潴留患者的疗效观察

Curative Effect of Pyridostigmine Bromide Combined with Tamsulosin in Treating Benign Prostatic Hyperplasia Patients Accompanied with Urinary Retention after Acute Cerebral Infarction

目的观察溴吡斯的明联合坦索罗辛治疗良性前列腺增生伴急性脑梗死后尿潴留患者的临床疗效。方法选取2016年1月-2018年5月西安市第四医院泌尿外科收治的良性前列腺伴急性脑梗死后尿潴留患者58例,根据治疗方法分为对照组(n=30)和观察组(n=28)。在常规治疗基础上,对照组患者给予坦索罗辛治疗,观察组患者给予溴比斯的明联合坦索罗辛治疗;两组患者均连续治疗14 d。比较两组患者入院第7天、第14天留置尿管拔管率、残余尿量(RUV)、最大尿流率(Qmax)及治疗前后国际前列腺症状评分(IPSS)、生活质量(QOL)评分,并观察两组患者治疗期间不良反应发生情况。结果(1)观察组患者入院第7天、第14天留置尿管拔管率高于对照组(P<0.05)。(2)两组患者治疗前IPSS、QOL评分比较,差异无统计学意义(P>0.05);观察组患者治疗后IPSS、QOL评分低于对照组(P<0.05)。(3)观察组患者入院第14天拔管RUV低于对照组,入院第7天、第14天Qmax均高于对照组(P<0.05);两组患者入院第7天RUV比较,差异无统计学意义(P>0.05)。(4)两组患者治疗期间均未发生明显不良反应。结论溴吡斯的明联合坦索罗辛可有效提高良性前列腺增生伴急性脑梗死后尿潴留患者留置尿管拔除率、生活质量及尿流量,改善患者临床症状,降低患者膀胱RUV,且安全性较高。

Objective To observe the curative effect of pyridostigmine bromide combined with tamsulosin in treating benign prostatic hyperplasia(BPH)patients accompanied with urinary retention after acute cerebral infarction.Methods From January 2016 to May 2018,a total of 58 BPH patients accompanied with urinary retention after acute cerebral infarction were selected in the Department of Urinary Surgery,the Forth Hospital of Xi’an,and they were divided into control group(n=30)and observation group(n=28)according to the therapeutic methods.Patients in control group were given tamsulosin based on conventional treatment,while patients in observation group were given pyridostigmine bromide based on that of control group;both groups continuously treated for 14 days.Extubation rate of indwelling urinary catheter,residual urine volume(RUV)and maximum urine flow rate(Qmax)were compared between the two groups 7 and 14 days after admission,moreover IPSS and QOL score were compared between the two groups before and after treatment;incidence of adverse reactions was observed during treatment.Results(1)Extubation rate of indwelling urinary catheter in observation group was statistically significantly higher than that in control group 7 and 14 days after admission,respectively(P<0.05).(2)No statistically significant difference of IPSS or QOL score was found between the two groups before treatment(P>0.05),while IPSS and QOL score in observation group were statistically significantly lower than those in control group after treatment(P<0.05).(3)RUV in observation group was statistically significantly lower than that in control group 14 days after admission,Qmax in observation group was statistically significantly higher than that in control group 7 and 14 days after admission,respectively(P<0.05),however,there was no statistically significant difference in RUV between the two groups 7 days after admission(P>0.05).(4)No one in the two groups occurred any obvious adverse reactions.Conclusion In BPH patients accompanied with urinary retention after acute cerebral infarction,pyridostigmine bromide combined with tamsulosin can effectively improve the extubation rate of indwelling urinary catheter,quality of life and urine flow rate,relieve the clinical symptoms and reduce residual urine volume,with relatively high safety.