CAJ | 학술논문

目的：探讨索利那新对尿道重建术后膀胱痉挛的预防作用。方法143例经尿道重建术治疗后的患者按随机单盲法分为：治疗组74例，其中38例穿刺亚组，切开亚组36例，对照组69例，其中35例穿刺亚组，切开亚组34例。治疗组服用索利那新片：5 mg／次，1次／d，服用7 d；对照组服用等剂量安慰剂。记录患者每日膀胱痉挛次数及持续时间，用视觉模拟量表（VAS）评估患者药物治疗后疼痛的程度及患者对治疗满意度。结果膀胱痉挛平均次数及每次持续时间平均值在用药前期治疗组与对照组差异无统计学意义（P＞0.05），但用药后期两组差异有统计学意义（P＜0.05）。治疗组的穿刺亚组出现膀胱痉挛持续时间明显少于对照组（P＜0.05），亚组之间比较差异无统计学意义（P＞0.05）。VAS评分在两组患者间比较总体差异无统计学意义（P＞0.05），但在治疗组内穿刺亚组与对照组穿刺亚组VAS评分差异明显（P＜0.05）。治疗组满意度为82.4％，高于对照组的56.5％（P＜0.05）。结论索利那新对尿道重建术并发症膀胱痉挛的预防有一定效果，其中对膀胱穿刺术型效果最明显，对膀胱切开造瘘术型效果较差。
목적：탐토색리나신대뇨도중건술후방광경련적예방작용。방법143례경뇨도중건술치료후적환자안수궤단맹법분위：치료조74례，기중38례천자아조，절개아조36례，대조조69례，기중35례천자아조，절개아조34례。치료조복용색리나신편：5 mg／차，1차／d，복용7 d；대조조복용등제량안위제。기록환자매일방광경련차수급지속시간，용시각모의량표（VAS）평고환자약물치료후동통적정도급환자대치료만의도。결과방광경련평균차수급매차지속시간평균치재용약전기치료조여대조조차이무통계학의의（P＞0.05），단용약후기량조차이유통계학의의（P＜0.05）。치료조적천자아조출현방광경련지속시간명현소우대조조（P＜0.05），아조지간비교차이무통계학의의（P＞0.05）。VAS평분재량조환자간비교총체차이무통계학의의（P＞0.05），단재치료조내천자아조여대조조천자아조VAS평분차이명현（P＜0.05）。치료조만의도위82.4％，고우대조조적56.5％（P＜0.05）。결론색리나신대뇨도중건술병발증방광경련적예방유일정효과，기중대방광천자술형효과최명현，대방광절개조루술형효과교차。
Objective To investigate the efficacy of solifenacin in the prevention of postoperative bladder spasm following urethral reconstruction.Methods 143 patients treated with urethral reconstruction were divided,by randomized single-blind method,into the exper-iment group of 74 cases,consist of 38 puncture cases and 36 incision cases,and the control group of 69 cases,consist of 35 puncture cases and 34 incision cases.The patients in the experiment group were given solifenacin 5 mg once daily for 7 days,while the patients in the con-trol group received placebo at the same dosage.The daily frequency and duration of bladder spasm were recorded,and then using visual ana-logue scale (VAS)to evaluate the degree of bladder pain and satisfaction situation in patients with medication.Results The average daily frequency and duration of bladder spasm in both groups had no significant difference within 1 ~3 days after the administration of solifenacin (P>0.05 ),but the difference in those indicators between the two groups became significant within 4~7 days after medication (P<0.05 ). In the puncture cases of experiment group,the bladder spasm duration was significantly shorter than that of the control group (P<0.05 ), but when comparison was made between the incision cases of the two groups,there was no significant difference (P>0.05 ).Overall VAS scores were compared between the two groups with no significant difference (P>0.05 ),but there were significant difference between the puncture cases of the two groups in VAS score (P<0.05 ).Satisfaction situation in the experiment group was also higher than that of the con-trol group.Conclusion Solifenacin indeed has prevention and treatment effect on postoperative bladder spasm,especially to patients treated with bladder puncture ostomy in the urethral reconstruction,and is worthy of popularization and application in clinical practice.