摘要
目的 研究骶神经电刺激与托特罗定联合治疗女性继发性膀胱过度活动症（SOAB）的疗效.方法 收集2006年8月-2012年8月确诊为SOAB的女性患者200例,随机分为两组,每组100例,每组又按尿频尿急、急迫性尿失禁和两种情况兼有分成三个Sub-group.治疗组采用经皮穿刺电刺激骶神经联合托特罗定2mg口服1次/日,对照组仅予托特罗定2mg口服1次/日,疗程为3个月,观察两组间的排尿日记及尿动力学参数,并通过治疗前后抑郁与焦虑的心理评分来分析各组患者的生活质量有无改善.结果 托特罗定虽然对这sub-group三组患者的尿次数、平均尿量和单次排尿量都有所改善,但是差异没有统计学上的意义;但是经过骶神经电刺激加托特罗定的治疗后,患者的尿次数、平均尿量和单次排尿量都比治疗前明显改善,差异有统计学上的意义（P＜0.01）.尤其是经过骶神经电刺激联合托特罗定治疗后的尿次数、平均尿量和单次排尿量都比托特罗定治疗后的有改善.同时首次排尿感觉容量（FDV）、最大膀胱压容量（MCBC）、最大尿流率（Qmax）情况,患者均有排尿次数减少,日平均尿量和最大排尿量明显增加的表现.3个月临床症状和尿动力学参数比较差异均有显著意义（P＜0.01）.结果还显示不仅两组治疗后的SDS和SAS均比治疗前明显减低（P＜0.01）,而且骶神经电刺激联合托特罗定可明显改进患者的生活质量,有统计学差异.结论 骶神经电刺激联合托特罗定治疗可改善女性SOAB患者的排尿功能障碍,改善由女性膀胱过度活动症引起的忧郁和焦虑征从而改善患者的生活质量,疗效优于单用托特罗定,有一定临床意义.
Objectives To evaluate the efficacy of combined sacral nerve stimulation and Tolterodine treatments for patients with Secondary female idiopathic overactive bladder（SOAB）.Methods A total of 200 Secondary female patients diagnosed with SOAB from August,2006 to August,2012 were included in the study and randomized into a solely Tolterodine treatment and a Tolterodine combined with sacral nerve stimulation group.Each group included 100 patients,which were further subdivided into 3 groups according to their symptoms of urinary frequency and urgency,urge incontinence,and both of them.In the treatment group,patients received percutaneous sacral nerve stimulation and tolterodine（2mg once daily）,while in the control group,only tolterodine（2mg once daily） was administered in a course of 3 months.The voiding diary and urodynamics parameters were observed between the two groups,while patients＇ quality of life scores as well as their psychological depression and anxiety scores were monitored before and after the treatments.Results Though the urinary frequency as well as average urine and single urine outputs were ameliorated in the three sub-groups treated solely by tolterodine,there was no statistical significance.In contrast,the urinary frequency,average and single urine outputs in patients treated by tolterodine combined with sacral nerve stimulation were statistically significant improved （P ＜ 0.01）.Particularly the conditions of first desire to void （FDV）,and maximum cystometric capacity （MCBC）,and maximum flow rate （Qmax） were superior and albeit the patients＇ urinary frequency was reduced,the daily average urine and maximum urine outputs were obviously increased with significant differences in the 3-month clinical symptoms and urodynamics parameters between the two groups（P ＜ 0.01）.In addition,the results also showed that the self-rating depression scale （SDS） and self-rating anxiety scale （SAS） were reduced in both groups after the treatments （P ＜ 0.01）,but with c
出处
《国际泌尿系统杂志》
2014年第6期870-874,共5页
International Journal of Urology and Nephrology
基金
2012年福建省自然科学基金（项目编号：2012J01434）
关键词
膀胱
过度活动性
电刺激
Urnary Bladder,Overactive
Electric Stimulation
