泌尿系结石术后留置双J管患者应用坦索罗辛、索利那新、双氯芬酸钠缓释片单药及联合用药对下尿路症状的影响评估

Evaluation of the effect of tamsulosin,solifenacin and diclofenac sodium sustained-release tablets alone and in combination on lower urinary tract symptoms in patients with indwelling double-J stent after urolithiasis surgery

目的分析泌尿系结石术后留置双J管患者应用坦索罗辛、索利那新、双氯芬酸钠缓释片单药治疗及联合用药对下尿路症状的影响。方法210例接受手术治疗且术后留置双J管的泌尿系结石患者,根据术后应用药物的不同分为对照A组(口服坦索罗辛)、对照B组(口服索利那新)、对照C组(口服双氯芬酸钠缓释片)、观察A组(口服坦索罗辛联合索利那新)、观察B组(口服坦索罗辛联合双氯芬酸钠缓释片)、观察C组(口服索利那新联合双氯芬酸钠缓释片)及观察D组(口服坦索罗辛、索利那新联合双氯芬酸钠缓释片),每组30例。比较七组患者膀胱储尿期症状、腰痛情况及血尿发生情况。结果对照A组、对照B组及对照C组术后3 d、术后1周、术后2周的膀胱过度活动症症状评分表(OABSS)评分及视觉模拟评分法(VAS)评分组间两两比较差异无统计学意义(P>0.05);观察A组、观察B组及观察C组术后3 d、术后1周、术后2周的OABSS评分及VAS评分组间两两比较差异无统计学意义(P>0.05);观察A组、观察B组、观察C组及观察D组术后3 d、术后1周、术后2周的OABSS评分及VAS评分均低于对照A组、对照B组及对照C组,差异有统计学意义(P<0.05);观察D组术后3 d、术后1周、术后2周的OABSS评分及VAS评分均低于观察A组、观察B组、观察C组,差异有统计学意义(P<0.05)。观察D组血尿发生率3.33%明显较对照A组的20.00%、对照B组的20.00%及对照C组的23.33%低,差异有统计学意义(P<0.05);对照A组、对照B组、对照C组及观察A组、观察B组、观察C组血尿发生率组间两两比较差异无统计学意义(P>0.05);观察A组、观察B组、观察C组与观察D组血尿发生率组间两两比较差异无统计学意义(P>0.05)。结论接受泌尿系结石手术且术后留置双J管的患者联合应用坦索罗辛、索利那新、双氯芬酸钠缓释片能够更加有效地促进下尿路症状改善,降低血尿发生风险,联合用药价值高于单药治疗。

Objective To analyze the effect of tamsulosin,solifenacin and diclofenac sodium sustained-release tablets alone and in combination on lower urinary tract symptoms in patients with indwelling double-J stent after urolithiasis surgery.Methods 210 patients with indwelling double-J stent after surgery for urinary calculi were divided into control group A(oral tamsulosin),control group B(oral solifenacin),control group C(oral diclofenac sodium sustained-release tablets),observation group A(oral tamsulosin and solifenacin),observation group B(oral tamsulosin and diclofenac sodium sustained-release tablets),observation group C(oral solifenacin and diclofenac sodium sustained-release tablets),and observation group D(oral tamsulosin,solifenacin and diclofenac sodium sustained-release tablets),each with 30 cases.The bladder storage symptoms,lumbago and hematuria of the seven groups were compared.Results There was no statistically significant difference in the comparison of Overactive Bladder Symptom Score(OABSS)scores and Visual Analogue Scale(VAS)scores of control group A,control group B,and control group C at 3 d postoperatively,1 week postoperatively,and 2 weeks postoperatively(P>0.05).Comparison of OABSS score and VAS score in observation group A,observation group B and observation group C at 3 d postoperatively,1 week postoperatively and 2 weeks postoperatively were not statistically significant(P>0.05).OABSS score and VAS score of observation group A,observation group B,observation group C and observation group D were lower than those of control group A,control group B and control group C at 3 d postoperatively,1 week postoperatively and 2 weeks postoperatively,and the differences were statistically significant(P<0.05).OABSS score and VAS score of observation group D were lower than those of observation group A,observation group B and observation group C at 3 d postoperatively,1 week postoperatively and 2 weeks postoperatively,and the differences were statistically significant(P<0.05).The incidence of hematuria of 3.33%in observation group D was significantly lower than 20.00%in control group A,20.00%in control group B and 23.33%in control group C.The difference was statistically significant(P<0.05).Comparison of the incidence of hematuria in control group A,control group B,control group C and observation group A,observation group B,observation group C showed no statistically significant difference(P>0.05).The difference in the incidence of hematuria was not statistically significant when compared among observation group A,observation group B,observation group C and observation group D(P>0.05).Conclusion The combination of tamsulosin,solifenacin and diclofenac sodium sustained-release tablets can effectively improve the lower urinary trac symptomst and reduce the risk of hematuria in patients with indwelling double-J stent after urolithiasis surgery,and the value of the combination was higher than that of monotherapy.