作者：苟泓燊1 ，李豫 2

单位：

1.710004 陕西省西安市第四医院泌尿外科　；2.710004 陕西省西安市第四医院神经内科；通信作者：李豫，E-mail：liyu0968@163.com

Units：

1.Department of Urinary Surgery，the Forth Hospital of Xi'an，Xi'an 710004，China；2.Department of Neurology，the Forth Hospital of Xi'an，Xi'an 710004，China；Corresponding author：LI Yu，E-mail：liyu0968@163.com

关键词：

前列腺增生；脑梗死；尿潴留；溴吡斯的明；坦索罗辛；治疗结果

Keywords：

Prostatic hyperplasia；Brain infarction；Urinary retention；Pyridostigmine bromide；Tamsulosin；Treament outcome

CLC：

R 697.32　R 743.33　R 694.55

DOI：

DOI：10.3969/j.issn.1008-5971.2020.03.021

Funds：

摘要：

目的　观察溴吡斯的明联合坦索罗辛治疗良性前列腺增生伴急性脑梗死后尿潴留患者的临床疗效。方法　选取 2016 年 1 月—2018 年 5 月西安市第四医院泌尿外科收治的良性前列腺伴急性脑梗死后尿潴留患者 58 例，根据治疗方法分为对照组（n=30）和观察组（n=28）。在常规治疗基础上，对照组患者给予坦索罗辛治疗，观察组患者给予溴比斯的明联合坦索罗辛治疗；两组患者均连续治疗 14 d。比较两组患者入院第 7 天、第 14 天留置尿管拔管率、残余尿量（RUV）、最大尿流率（Qmax）及治疗前后国际前列腺症状评分（IPSS）、生活质量（QOL）评分，并观察两组患者治疗期间不良反应发生情况。结果　（1）观察组患者入院第7天、第14天留置尿管拔管率高于对照组（P<0.05）。（2）两组患者治疗前 IPSS、QOL 评分比较，差异无统计学意义（P>0.05）；观察组患者治疗后 IPSS、QOL 评分低于对照组（P<0.05）。 （3）观察组患者入院第14天拔管RUV低于对照组，入院第7天、第14天Qmax均高于对照组（P<0.05）；两组患者入院第 7 天 RUV 比较，差异无统计学意义（P>0.05）。（4）两组患者治疗期间均未发生明显不良反应。结论　溴吡斯的明联合坦索罗辛可有效提高良性前列腺增生伴急性脑梗死后尿潴留患者留置尿管拔除率、生活质量及尿流量，改善患者临床症状，降低患者膀胱 RUV，且安全性较高。

Abstract：

Objective　To observe the curative effect of pyridostigmine bromide combined with tamsulosin in treatingbenign prostatic hyperplasia（BPH）patients accompanied with urinary retention after acute cerebral infarction. Methods　FromJanuary 2016 to May 2018，a total of 58 BPH patients accompanied with urinary retention after acute cerebral infarction wereselected in the Department of Urinary Surgery，the Forth Hospital of Xi'an，and they were divided into control group（n=30）and observation group（n=28） according to the therapeutic methods. Patients in control group were given tamsulosin based onconventional treatment，while patients in observation group were given pyridostigmine bromide based on that of control group；both groups continuously treated for 14 days. Extubation rate of indwelling urinary catheter，residual urine volume（RUV）andmaximum urine flow rate（Qmax）were compared between the two groups 7 and 14 days after admission，moreover IPSS andQOL score were compared between the two groups before and after treatment；incidence of adverse reactions was observed duringtreatment. Results　（1）Extubation rate of indwelling urinary catheter in observation group was statistically significantly higherthan that in control group 7 and 14 days after admission，respectively（P<0.05）.（2）No statistically significant differenceof IPSS or QOL score was found between the two groups before treatment（P>0.05），while IPSS and QOL score in observationgroup were statistically significantly lower than those in control group after treatment（P<0.05）.（3）RUV in observation groupwas statistically significantly lower than that in control group 14 days after admission，Qmax in observation group was statisticallysignificantly higher than that in control group 7 and 14 days after admission，respectively（P<0.05），however，there wasno statistically significant difference in RUV between the two groups 7 days after admission（P>0.05）.（4）No one in the twogroups occurred any obvious adverse reactions. Conclusion　In BPH patients accompanied with urinary retention after acutecerebral infarction，pyridostigmine bromide combined with tamsulosin can effectively improve the extubation rate of indwellingurinary catheter，quality of life and urine flow rate，relieve the clinical symptoms and reduce residual urine volume，withrelatively high safety.

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