索利那新治疗前列腺电切术后膀胱过度活动症的临床观察

目的比较索利那新及托特罗定治疗经尿道前列腺电切术（TURP）术后患者膀胱过度活动症（OAB）的有效性与安全性。方法选取126例TURP后出现OAB症状的患者,随机分为4组：A组（索利那新5mg,1次/d）,B组（索利那新10mg,1次/d）,C组（托特罗定2mg,2次/d）,D组（安慰剂组）。术后6h开始服药,观察治疗前及拔管后7d日间排尿次数、夜间排尿次数、尿急、急迫性尿失禁以及对日常生活造成的影响。进一步进行OAB症状评分表（OABSS）评分和感知膀胱症状量表（PPBC）评分;观察各组口干、便秘、视力模糊症状等不良反应的发生率以及肝功能、肾功能指标变化。结果拔管后7d,A、B、C组与D组OABSS及PPBC评分有显著性差异（P〈0.05）,A、B组,B、C组,A、C组之间无显著性差异（P〉0.05）。A组2例出现口干,1例便秘;B组5例口干,3例便秘,2例视力模糊;C组有4例口干,2例便秘,1例视力模糊;D组仅1例便秘。各组第7d复查的肝功能、肾功能与术前相比无统计学差异（P〉0.05）。结论索利那新治疗TURP术后OAB症状比托特罗定更安全,5mg足以发挥疗效,副作用更少。

Clinical study of Solifenacin in treating patients with overactive bladder after transurethral resection of prostate

Objective To compare the efficacy and safety of Solifenacin and Toterodine in treating patients with overac- tive bladder（OAB） after transurethral resection of prostate（TURP）. Methods 126 patients with OAB after TURP were randomly divided into four groups： group A （Solifenacin, 5rag, q.d）, group B （Solifenacin, 10mg, q. d）, group C （Toterodine, 2rag, b.i. d）, and group D （placebo, thecontrol group）. The medication started 6 hours after extubation. Daytime and nighttime voiding frequency, urgency, urge incontinence and the impact on daily life were observed before treatment and 7 days after operation. OAB symptom scale （OABSS） score and the perception of bladder symptoms scale （PPBC） score were recorded after the catheter was pulled out; the adverse reactions such as xerostomia, constipation, blurred vision and the liver and renal function changes were also observed. Results There were statistical differences of OABSS and PPBC scores between group A, B, C and group D 7d after extubation （P〈0. 05）, and group A and B, B and C, A and C had no significant difference （P 〉0.05）. In group A, 2 patients had dry mouth, and 1 had constipation. In group B, 5 patients had dry mouth, 3 had constipation, and 2 had blurred vision. In group C, 4 had dry mouth, 2 had constipation, and 1 had blurred vision. In group D, 1 patient had constipation. Liver and renal function of patients in the 4 groups had no significant difference before and after treatment （P〉0.05）. Oonclusion Solifenacin could be safer than Toterodine in the treatment of patients with OAB after TURP, and 5 mg is enough to produce curative effect with less side effects.