伴残余尿的尿道综合征的临床研究

目的 :分析伴有残余尿的尿道综合征的临床特点 ,总结其治疗体会。方法 :对 6 8例尿道综合征患者行尿动力学检查和残余尿的测定 ,将其分为伴有残余尿 (A)和无残余尿 (B)两组。所有病例均先用双氯芬酸钠栓5 0mg塞肛Tid× 7d ,对症治疗。对于有残余尿者 ,依治疗后残余尿减少情况及尿动力学检查结果酌情给予新斯的明或哈乐和尿道扩张等治疗。结果 :A组 2 5例 ,B组 4 3例 ,双氯芬酸钠栓治疗 1周后 ,A组疗效显著 7例 ,有效 10例 ,无效 8例 ,B组疗效显著 2 6例 ,有效 9例 ,无效 8例。A组残余尿减少 5例 ,消失 3例 ,无效 13例 ,对残余尿无减少者行尿道扩张和 /或新斯的明或哈乐等治疗后 ,残余尿明显减少或消失。结论 :伴有残余尿的患者多病程相对较长 ,症状较重 ,发作频繁 ,病情与精神情绪等因素关系密切。双氯芬酸钠栓治疗 ,能有效缓解临床症状 ,但对残余尿的减少作用相对较差 ,尤其是残余尿量大于 5 0ml以上者 ,多需结合尿动力学检查情况采取尿道扩张 ,新斯的明或哈乐等配合治疗 ,才能收到较为满意的阶段性效果

CLINICAL FEATURE AND TREATMENT OF URETHRAL SYNDROME WITH RESIDUAL URINE

Objective:To analyze clinical feature of urethral syndrome with residual urine and summarize available treatments.Methods:Sixty-eight patients with urethral syndrome received urodynamic examinations and their residual urine was measured. Then they were divided into two groups -one with residual urine, another without. Symptomatic treatment with 50 mg of diclofenac sodium suppository was given through anus to all patients three times a day for 7 days. After that the patients with residual urine received therapy as Neostigminum or Harnal capsule ( Tamsulosin Hydrochloride) or urethral dilatation respectively according to the reduced amount of residual urine and results of urodynamic examination. Results:There were 25 patients in group A and 43 patients in group B. After one-week treatment with diclofenac sodium suppository, in group A, 7 cases showed significant effects, 10 cases showed effective, 8 cases showed no effect. In group B,the data were 26, 9 and 8 cases respectively. In group A, the residual urine reduced in 5 cases, dissapeared in 3 cases, didn't change in 13 cases. Treatment as Neostigminum or Harnal or urethral dilatation was given to those who did not show reduced residual urine. After that, the residual urine reduced markedly or disappeared.Conclusion:Most patients with residual urine have longer clinical courses, heavier symptoms and frequenter attacks. The clinical situation is closely related to psychological factors and moods of the patients.Diclofenac sodium suppository can relieve clinical symptoms effectively. But it shows poor effects on reducing residual urine, especially to whose residual urine more than 50 ml. After considering the results of urodynamic examination, combination therapy as urethral dilatation or Neostigminum or Harnal is needed in most cases to achieve satisfactory periodic effects.