坦洛新联合托特罗定治疗留置双J管后相关症状的临床观察

目的：观察坦洛新联合托特罗定治疗留置双J管后相关症状的效果。方法输尿管镜碎石术后留置双J管患者106例，随机分为2组， A组（坦洛新组）：接受坦洛新（0.2mg 1次/d）治疗；B组（联合用药组）：接受坦洛新（0.2mg 1次/d）和托特罗定（2mg 2次/d）治疗。106例患者随访4周，术前1d及术后4周拔双J管时填写IPSS评分表、膀胱过度活动症症状评分（OABSS）及生活质量评分（QOL）量表。结果106例患者均完成研究。两组术后4周尿急症状评分分别为（3.3±0.9）分与（0.9±0.2）分；IPSS评分分别为（11.5±1.8）分与（8.9±1.3）分；OABSS评分分别为（8.3±1.8）分与（3.7±1.6）分；QOL评分分别为（39.7±13.2）分与（18.2±10.6）分，组间比较差异均有统计学意义（P＜0.05）。结论留置双J输尿管支架管严重影响患者生活质量，坦洛新联合托特罗定能明显改善留置输尿管支架管后相关症状，提高患者生活质量。

Evaluation of Combination Therapy with Tamlosin and Tolterodine for the Treatment of the Double J Stent-related Symtoms

Objective To evaluate the effect of combination therapy with tamlosin and tolterodine improving symtoms in patients with indweling double-J ureteral stents. Methods A total of 106 patients underwent placement of a double-J ureteral stent after retrograde ureteroscopy for urinary stone disease, which were prospectively randomized （random numbers table） into two groups. The tamlosin group （n=53） was administered tamlosin 0.2 mg once daily, the combination group （n=53） was administered tamlosin 0.2 mg once daily and tolterodine 2 mg twice daily. All the patients completed a validated the Overactive Blader Symptom Score（OABSS） urgency score, the International Prostate Symtom Score （IPSS）, the Overactive Blader Symptom Score（OABSS）, the Quality Of Life Score （QOL） one day before the placement and 4 weeks after stent placement of stent. Results There was a statistically signiifcant difference between tamlosin group and combination group in the OABSS urgency score （3.3±0.9vs0.9±0.2）, IPSS score （11.5±1.8vs8.9±1.3）, OABSS score（8.3±1.8vs3.7±1.65）, QOL score（39.7±13.2vs18.2±10.6）at the 4 week follow-up. Differences between groups were statistically signiifcant （P〈0.05）.Conclusions Indwelling ureteral stents have a signiifcant impact on health related quality of life. It is effective for improving symptoms in patients with indwelling double-J ureteral stents by combination therapy with tamlosin and tolterodine.