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[目的]通过观察经尿道前列腺电切(TURP)术前使用辣椒辣素类似物RTX(Resiniferatoxin)对术后膀胱痉挛和拔除尿管后排尿日记的影响,探讨RTX预防和治疗TURP术后早期膀胱过度活动症症状的临床疗效。[方法]随机对45例BPH病人进行研究,平均年龄(67.84±6.92)岁(52~85岁),平均病程是(6.89±5.69)年(0.6~20年)。将病人分成3组,每组15人,膀胱灌注RTX组(A组),口服托特罗定组(B组)和空白对照组(C组)。其中A组使用浓度为10-8mol/L的RTX溶液100ml在术前膀胱灌注,保留30min;B组在TURP术前口服托特罗定,每次2mg一天两次;C组作为A组的空白对照,术前灌注生理盐水100ml。观察膀胱痉挛的发生次数、持续时间以及通过排尿日记记录排尿次数,同时观察试验组与对照组的并发症发生率。[结果]灌注RTX没有出现膀胱不适和副作用,不需要局部麻醉。使用RTX1d后OAB症状得以改善。1周后排尿日记显示白天排尿次数和夜间排尿次数均明显改善(P﹤0.001)。症状评分、膀胱痉挛次数、持续时间拔除尿管时间等比空白对照组明显改善。[结论]术前膀胱灌注RTX可以有效地预防和减轻TURP术后OAB,通过预防OAB改善术后膀胱功能,减小副作用发生率,可作为膀胱过度活动症引起的下尿路症状的一种有效治疗手段。
[Objective] To observe the effect of RTX (Resiniferatoxin) on postoperative bladder spasm and urinary diuretic diuresis after preoperative transurethral resection of prostate (TURP), and to explore the effect of RTX on prevention and treatment of early bladder after TURP Over-active symptoms of clinical efficacy. [Methods] A total of 45 BPH patients were studied. The mean age was (67.84 ± 6.92) years (52-85 years) and the average duration was (6.89 ± 5.69) years (0.6-6 years). The patients were divided into three groups of 15, each group received intravesical instillation of RTX (group A), oral tolterodine (group B) and blank control (group C). A group of 100ml RTX solution with a concentration of 10-8mol / L was preoperatively infused into the bladder for 30min. In group B, tolterodine was administered orally twice a day before TURP. In group C, Control, preoperative perfusion saline 100ml. Observe the incidence of bladder spasm, the duration of urination and diuresis through the number of urination records, while observing the experimental group and control group, the incidence of complications. [Results] There was no urinary bladder discomfort and side effects in perfusion RTX, and no local anesthesia was required. OAB symptoms improved after using RTX1d. One week later, the diuresis showed a significant improvement in the number of urination during the day and night urination (P <0.001). Symptom score, the number of bladder spasms, duration of catheter removal, etc. than the blank control group was significantly improved. [Conclusion] Preoperative intravesical instillation of RTX can effectively prevent and reduce OAB after TURP. It can be used as an effective treatment of lower urinary tract symptoms caused by overactive bladder by preventing OAB from improving postoperative bladder function and reducing the incidence of side effects treatment approach.