骶神经电刺激联合托特罗定治疗女性特发性膀胱过度活动症的临床研究
저신경전자격연합탁특라정치료녀성특발성방광과도활동증적림상연구
Clinical research of sacral nerve stimulation combined with tolterodine in patients with female idiopathic overactive bladder
  • 万方数据
    中国医师进修杂志 중국의사진수잡지
    CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
    2013年 32期 32-35 ,共4页

    唐华%陈剑%王永富%俞婷%郭昌平%廖小七

    당화%진검%왕영부%유정%곽창평%료소칠

    经皮神经电刺激%膀胱,过度活动性%托特罗定 經皮神經電刺激%膀胱,過度活動性%託特囉定
    경피신경전자격%방광,과도활동성%탁특라정
    Transcutaneous nerve stimulation%Urinary bladder,overactive%Tolterodine
    目的 研究骶神经电刺激联合托特罗定治疗女性特发性膀胱过度活动症(IOAB)的疗效.方法 收集2005年1月至2011年1月确诊为IOAB的女性患者200例,按随机数字表法分为治疗组和对照组,每组100例,每组又按尿频尿急、急迫性尿失禁和两种情况兼有分成三个亚组.治疗组采用经皮穿刺电刺激骶神经联合托特罗定2 mg口服,1次/d,对照组仅给予托特罗定2 mg口服,1次/d,疗程为3个月,观察两组治疗前后排尿日记及尿动力学参数,并应用忧郁自评量表(SDS)与焦虑自评量表(SAS)进行抑郁与焦虑的心理评分.结果 两组治疗后日平均排尿次数、日平均单位尿量、日单次最大尿量及排尿感觉容量(FDV)、最大膀胱压容量(MCBC)、最大尿流率(Qmax)均有所改善,且治疗组治疗后日平均单位尿量、日单次最大尿量及FDV、MCBC均高于对照组[日平均单位尿量:尿频尿急(248±46) ml/次比(150±77)ml/次,急迫性尿失禁(249±69) ml/次比(144±81) ml/次,两种情况兼有(247±69) ml/次比(170±46) ml/次;日单次最大尿量:(320±87) ml/次比(212±44) ml/次,(315±65) ml/次比(211±56) ml/次,(333±59) ml/次比(201±66) ml/次;FDV:(176±64) ml比(142±44) ml,(190±69) ml比(142±55) ml,(188±60) ml比(138±49) ml; MCBC:(265±46)ml比(203±50) ml,(288±48) ml比(197±41) m1,(287±43) ml比(189±44) ml],差异有统计学意义(P＜0.01).两组治疗后SDS和SAS评分显著下降,且治疗组治疗后SDS和SAS评分显著低于对照组[SDS评分:尿频尿急(33.0±6.2)分比(44.0±5.9)分,急迫性尿失禁(31.1 ±6.2)分比(41.6±6.1)分,两种情况兼有(33.4±7.2)分比(44.5±5.0)分;SAS评分:(30.3±4.4)分比(41.3±4.4)分,(33.3±5.8)分比(42.5±6.4)分,(31.9±4.7)分比(43.5±5.6)分],差异均有统计学意义(P＜0.01).结论 骶神经电刺激联合托特罗定治疗可改善女性IOAB患者的排尿功能障碍,改善由女性膀胱过度活动症引起的抑郁和焦虑,从而改善患者的生活质量.
    목적 연구저신경전자격연합탁특라정치료녀성특발성방광과도활동증(IOAB)적료효.방법 수집2005년1월지2011년1월학진위IOAB적녀성환자200례,안수궤수자표법분위치료조화대조조,매조100례,매조우안뇨빈뇨급、급박성뇨실금화량충정황겸유분성삼개아조.치료조채용경피천자전자격저신경연합탁특라정2 mg구복,1차/d,대조조부급여탁특라정2 mg구복,1차/d,료정위3개월,관찰량조치료전후배뇨일기급뇨동역학삼수,병응용우욱자평량표(SDS)여초필자평량표(SAS)진행억욱여초필적심리평분.결과 량조치료후일평균배뇨차수、일평균단위뇨량、일단차최대뇨량급배뇨감각용량(FDV)、최대방광압용량(MCBC)、최대뇨류솔(Qmax)균유소개선,차치료조치료후일평균단위뇨량、일단차최대뇨량급FDV、MCBC균고우대조조[일평균단위뇨량:뇨빈뇨급(248±46) ml/차비(150±77)ml/차,급박성뇨실금(249±69) ml/차비(144±81) ml/차,량충정황겸유(247±69) ml/차비(170±46) ml/차;일단차최대뇨량:(320±87) ml/차비(212±44) ml/차,(315±65) ml/차비(211±56) ml/차,(333±59) ml/차비(201±66) ml/차;FDV:(176±64) ml비(142±44) ml,(190±69) ml비(142±55) ml,(188±60) ml비(138±49) ml; MCBC:(265±46)ml비(203±50) ml,(288±48) ml비(197±41) m1,(287±43) ml비(189±44) ml],차이유통계학의의(P＜0.01).량조치료후SDS화SAS평분현저하강,차치료조치료후SDS화SAS평분현저저우대조조[SDS평분:뇨빈뇨급(33.0±6.2)분비(44.0±5.9)분,급박성뇨실금(31.1 ±6.2)분비(41.6±6.1)분,량충정황겸유(33.4±7.2)분비(44.5±5.0)분;SAS평분:(30.3±4.4)분비(41.3±4.4)분,(33.3±5.8)분비(42.5±6.4)분,(31.9±4.7)분비(43.5±5.6)분],차이균유통계학의의(P＜0.01).결론 저신경전자격연합탁특라정치료가개선녀성IOAB환자적배뇨공능장애,개선유녀성방광과도활동증인기적억욱화초필,종이개선환자적생활질량.
    Objective To study the efficacy of sacral nerve stimulation combined with tolterodine in patients with female idiopathic overactive bladder (IOAB).Methods A total of 200 female patients diagnosed with IOAB from January 2005 to January 2011 were included in the study,and according to random number table method were divided into treatment group and control group with 100 cases in each.Each group was divided into 3 subgroups according to urinary frequency and urgency,urge incontinence,and both of them together.In the treatment group,patients received percutaneous sacral nerve stimulation and tolterodine 2 mg orally,1 time/d,while in the control group,only given tolterodine 2 mg orally,1 time/d,treatment for 3 months.The voiding diary and urodynamics parameters were observed between the two groups before and after treatment and application of self-rating depression scale (SDS) and self-rating anxiety scale (SAS) to evaluate the psychology of concomitant depression and anxiety score.Results After treatment,the average number of urination,daily average unit urine,the single biggest urine and urine feel capacity (FDV),the maximum capacity of the bladder pressure (MCBC),maximum urinary flow rate (Qmax) in two groups were improved,and the daily average unit urine,single biggest urine and FDV,MCBC,Qmax in treatment group after treatment were higher than those in control group [daily average unit urine:urinary frequency and urgency (248 ± 46) ml/times vs.(150 ± 77) ml/times,urge incontinence (249 ± 69) ml/times vs.(144 ± 81) ml/times,both of them together (247 ± 69) ml/times vs.(170 ± 46) ml/times; the single biggest urine:(320 ± 87) ml/times vs.(212 ± 44) ml/times,(315 ± 65) ml/times vs.(211 ± 56) ml/times,(333 ±59) ml/times vs.(201 ±66) ml/times;FDV:(176 ±64) ml vs.(142 ±44) ml,(190 ±69) ml vs.(142±55) ml,(188 ±60) mlvs.(138 ±49) ml;MCBC:(265 ±46) ml vs.(203 ±50) ml,(288 ±48) ml vs.(197 ± 41)ml,(287 ± 43) ml vs.(189 ± 44) ml],there were significant statistical differences (P ＜ 0.01).The SDS and SAS scores were reduced in two groups after treatment,and the SDS and SAS scores in treatment group after treatment were significantly lower than those in control group [SDS scores:urinary frequency and urgency (33.0 ± 6.2) scores vs.(44.0 ± 5.9) scores,urge incontinence(31.1 ± 6.2) scores vs.(41.6 ± 6.1) scores,both of them together(33.4 ± 7.2) scores vs.(44.5 ± 5.0)scores;SAS scores:(30.3 ± 4.4) scores vs.(41.3 ±4.4) scores,(33.3 ±5.8) scores vs.(42.5 ±6.4) scores,(31.9 ±4.7) scores vs.(43.5 ± 5.6) scores],there were significant statistical differences (P＜ 0.01).Conclusions The combined treatment of tolterodine and sacral nerve stimulation can not only improve the voiding dysfunctions symptoms but also the concomitant depression and anxiety in patients with female IOAB,thus improving the patient's quality of life.
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