不同方式解除经尿道前列腺电切术后膀胱痉挛的疗效比较

【目的】观察采用静脉镇痛泵、琥珀酸索利那新片、酒石酸托特罗定缓释片联合静脉镇痛泵治疗经尿道前列腺电切术（TURP）后膀胱痉挛的疗效。【方法】将本院80例行TURP术后患者随机均分为四组。对照组于膀胱痉挛出现后给予哌替啶50 mg联合山莨菪碱10 mg 肌肉注射。静脉镇痛泵组手术后患者保留静脉镇痛泵导管，连接静脉输液（镇痛液配方为舒芬太尼100μg＋格拉司琼6 mg ，用生理盐水稀释至100 mL ），调节药量为恒速注药2mL，维持72h。索利那新组手术前1d口服琥珀酸索利那新片每次5mg，1次/日；联合用药组手术前1d口服酒石酸托特罗定缓释片每次2mg ，1次/日，同时联合静脉镇痛泵治疗。比较各组临床疗效。【结果】试验三组术后d1，d2，d3膀胱痉挛次数、膀胱痉挛平均持续时间、膀胱冲洗液转清时间均短于对照组，联合用药组的膀胱痉挛次数及膀胱痉挛平均持续时间均短于静脉镇痛泵组及索利那新组，且各组之间比较差异均有显著性（均 P ＜0．05），静脉镇痛泵组及索利那新组各项指标相比较差异无显著性（ P ＞0．05）。【结论】静脉镇痛泵、琥珀酸索利那新片、酒石酸托特罗定缓释片联合静脉镇痛泵三种方式对于预防和治疗术T U RP后早期膀胱痉挛均有较好的效果，且联合用药组效果更加显著，可在临床推广。

Comparison of the Efficacy of Different Methods for Relieving Cystospasm after Transurethral Prostatic Resection

[Objective] To observe the efficacy of patient-controlled intravenous analgesia （PCA ） ,succinic acid solifenacin tablet and tolterodine tartrate sustained release tablet combined with PCA for the treatment of cystospasm after transurethral prostatic resection（TURP） .[Methods] Totally 80 patients after TURP in our hospital were ran-domly divided into 4 groups .The control group was given pethidine 50mg and anisodamine 10mg by muscle injection . PCA group was given continuous venous injection with sufentanil 100μg and granisetron 6mg by vein analgesia pump , which were diluted to 100mL with normal saline ,and the dosage was adjusted into 2mL by constant speed for 72h . Solifenacin group was given oral succinic acid solifenacin tablet 5mg for once a day .The combination group was given oral tolterodine tartrate sustained release tablet 2mg for once a day and PCA therapy .Clinical efficacy was compared among groups .[Results]The frequency and mean duration of cystospasm and bladder washout times in 3 experimental groups d1 ,d2 and d3 after operation were shorter than those in control group .The frequency and mean duration of cystospasm in combination group were shorter than those in PCA group and solifenacin group ,and there was signifi-cant difference among groups （all P〈0 .05） .There was no significant difference in all indicators between PCA group and solifenacin group（ P〉0 .05） .[Conclusion]PCA ,succinic acid solifenacin tablet and tolterodine tartrate sustained release tablet combined with PCA for the prevention and treatment of early cystospasm after TURP have good effica-cy .The combination group has more significant efficacy and should be promoted in clinical practice .