索利那新联合坦索罗辛治疗输尿管支架管置入术后下尿路症状的疗效分析

目的：探讨索利那新联合坦索罗辛治疗输尿管支架管置入术后下尿路症状的疗效。方法选择2014年9月至2015年8月在我院泌尿外科住院治疗的单侧输尿管镜检查或单侧输尿管镜取石术后患者148例进行为期4周的治疗、随访。按照简单随机抽样的方法分为A、B、C三组，A组(n=49)：坦索罗辛胶囊0.2 mg，口服，每天晚上1次；B组(n=49)：索利那新片5 mg，口服，每天1次；C组(n=50)：坦索罗辛缓释胶囊(0.2 mg口服，每天晚上1次)+索利那新片(0.5 mg，口服，每天1次)。总疗程均为4周。所有患者在术后第2天及拔管当日分别完成国际前列腺症状评分(IPSS）、生活质量评估(Qol)和可视化疼痛评分(VAS)。结果三组患者治疗期间均无严重不良反应，均顺利参与研究并配合随访。C组经索利那新联合坦索罗辛治疗4周后IPSS总评分(7.07±3.21)分]、IPSS刺激性症状评分(3.75±2.69)分]、Qol评分(1.48±1.32)分]均有显著的下降，与A组(12.33±4.63)分、(7.22±3.78)分、(3.12±1.86)分]或B组(10.95±5.13)分、(5.75±4.32)分、(2.94±1.77)分]比较差异均具有统计学意义(P<0.05)。C组术后4周与其术后第2天(11.55±4.12)分、(7.42±3.56)分、(2.38±1.49)分]比较，IPSS总评分、IPSS刺激症状评分、Qol评分差异也具有统计学意义(P<0.05)。而C组的IPSS梗阻症状评分(3.98±2.21)分及VAS评分(2.12±1.45)分与A组(4.56±3.14)分、(2.60±1.96)分]或B组(5.07±3.10)分、(2.78±1.81)分]差异均无统计学意义(P>0.05)。A组与B组比较，各项评分差异均无统计学(P>0.05)。结论索利那新联合坦索罗辛可有效改善输尿管支架管下尿路症状，优于单独服用坦索罗辛或索利那新，极大地提高了患者的生活质量，值得临床推广应用。

Curative effect of Solifenacin combinied with Tamsulosin in the treatment of lower urinary tract symptoms after imbedding ureteral stent

Objective To discuss the curative effect of Solifenacin combined with Tamsulosin for treating low-er urinary tract symptoms after imbedding ureteral stent. Methods A total of 148 patients in the Department of Urinary Surgery in our hospital from Sep. 2014 to Aug. 2015 treated with unilateral ureteroscopy or unilateral ureteroscopic litho-tripsy were enrolled in the study, which were treated and followed up for 4 weeks. The patients were divided into three groups:group A (n=49, 0.2 mg Tamsulosin Hydrochloride Capsules, take orally, 1 time/night), group B (n=49, 5 mg Soli-fenacin Succinate Tablets, take orally, once a day), group C (n=50, 0.2 mg Tamsulosin Hydrochloride Capsules, take oral-ly, 1 time/night+0.5 mg Solifenacin Succinate Tablets, take orally, once a day). The course of treatment was 4 weeks af-ter operation. International Prostate Symptom Score (IPSS) and Quality of Life (Qol) and Visual Analogue Scale (VAS) were evaluated two days after operation and at extubation. Results Patients in the three groups showed no severe ad-verse reactions during the follow-up. Four weeks after treatment, the IPSS total symptom score (7.07±3.21)], IPSS stim-ulation symptom score (3.75 ± 2.69)], and Qol (1.48 ± 1.32)] in group C were significantly lower than those in group A (12.33±4.63), (7.22±3.78), (3.12±1.86)] and group B (10.95±5.13), (5.75±4.32), (2.94±1.77)], P<0.05. IPSS total symp-tom score, IPSS stimulation symptom scores, Qol score in group C also showed statistically significant difference be-tween 2 days after operation (11.55±4.12), (7.42±3.56), (2.38±1.49)] and 4 weeks after operation (P<0.05). IPSS ob-struction symptom score and VAS score in group C (3.98±2.21), (2.12±1.45)] showed no statistically significant dif-ference with those in group A (4.56±3.14), (2.60±1.96)] or group B (5.07±3.10), (2.78±1.81)], P>0.05. All the index-es showed no statistically significant difference between group A and group B. Conclusion Solifenacin combined with Tamsulosin can improve lower urinary tract symptoms of urethral stent and greatly improve patients' quality of life, which is superior to Tamsulosin Hydrochloride Capsules or Solifenacin Succinate Tablets singly and is deserved to be ap-plied clinically.