吴小云　向紫兵　徐辉

[摘要] 目的 观察短期大剂量爱普列特联合坦络新治疗前列腺增生症并尿潴留的疗效及安全性。 方法 将2006年6月～2014年6月在本院就诊的50例良性前列腺增生症并尿潴留患者随机分为观察组（30例）和对照组（20例）。观察组给予爱普列特10 mg，口服，2次/d；坦络新0.4 mg，口服，每晚1次。对照组给予爱普列特5 mg，口服，2次/d；坦络新0.2 mg，口服，每晚1次。治疗4周后，观察两组患者尿管拔除率及拔除时间，两组恢复自主排尿患者最大尿流率、膀胱残余尿量，同时观察两组患者治疗过程中的不良反应发生情况。 结果 观察组27例拔除尿管，尿管拔除率为90.00%；对照组11例拔除尿管，尿管拔除率为55.00%；观察组尿管拔除率显著高于对照组（P<0.05）。观察组尿管拔除时间显著短于对照组（P<0.05）。观察组27例恢复自主排尿患者平均最大尿流率为（14±4） ml/s，平均膀胱残余尿量为（25±6） ml；对照组11例恢复自主排尿患者平均最大尿流率为（10±3） ml/s，平均膀胱残余尿量为（40±8） ml；观察组平均最大尿流率高于对照组（P<0.05），平均膀胱残余尿量低于对照组（P<0.05）。50例患者治疗过程中无严重不良事件而停止服药或减量服药。 结论 短期大剂量爱普列特联合坦络新治疗前列腺增生症并尿潴留安全，有效，可避免或推迟手术及尿流改道。

[关键词] 良性前列腺增生；尿潴留；爱普列特

[中图分类号] R697+.32 [文献标识码] A [文章编号] 1674-4721（2015）01（b）-0115-04

Effect observation of short-term large doses epristeride tablets combined with tamsulosin hydrochloride sustained release tablets in treatment of benign prostatic hyperplasia and urinary retention

WU Xiao-yun XIANG Zi-bing XU Hui

Department of Urology，the 457th Hospital of PLA，Wuhan 430012，China

[Abstract] Objective To evaluate the effect of short-term large doses epristeride tablets combined with tamsulosin hydrochloride sustained release tablets in treatment of benign prostatic hyperplasia and urinary retention. Methods 50 cases of patients with benign prostatic enlargement and urinary retention were randomly divided into observation group （30 patients） and control group （20 patients）.The observation group were taken with epristeride tablets every time 10 mg，two times a day，and taken with tamsulosin hydrochloride sustained release tablets every time 0.4 mg，once a day at night.The control group were taken with epristeride tablets every time 5 mg，two times a day，and taken with tamsulosin hydrochloride sustained release tablets 0.2 mg every time，once a day at night.After four weeks treatment，the ratio and time of removing catheter，and the maximal urinary flow rate and postvoid residual urine of patients with the automatic micturition ability recovered in the two groups were evaluated.Meanwhile，the adverse effect in the two groups were observed and recorded. Results The catheter removal rate of observation group was 90.00% （27/30），higher than 55.00% （11/20） of the control group，the difference was significant （P<0.05）.The catheter removing time of observation group was shorter than that of control group，the difference was significant （P<0.05）.The average maximal urinary flow rate of the 27 patients with the automatic micturition ability recovered in the observation group was （14±4） ml/s，and the average postvoid residual urine was （25±6） ml；While the average maximal urinary flow rate and the average postvoid residual urine of the 11 patients with automatic micturition recovered in the control group was （10±3） ml/s and （40±8） ml respectively.The average maximal urinary flow rate in the observation group was higher than that in the control group （P<0.05），and the average postvoid residual urine in the observation group was lower than that in the control group （P<0.05）.No serious side effect was observed that caused drug withdraw and reduction during the drug treatment among the 50 patients. Conclusion Short-term large doses epristeride tablets combined with tamsulosin hydrochloride sustained release tablets in treatment of benign prostatic enlargement and urinary retention is effective and safe，can avoid postpone surgery and urethra rechanneling.

[Key words] Benign prostatic hyperplasia；Urinary retention；Epristeride

尿潴留是良性前列腺增生症患者常见的并发症，临床中常行留置尿管，口服常规剂量α受体阻滞剂、5α-还原酶抑制剂治疗，但大多数患者1个月内多次试行拔除尿管仍不能恢复自主排尿，须手术或尿流改道治疗[1]。患者因高龄，合并多种基础性疾病不能耐受麻醉手术风险，或患者顾虑畏惧手术及尿流改道后影响生活质量，强烈要求先药物保守治疗。本科采用短期大剂量爱普列特及坦络新治疗前列腺增生症并尿潴留，取得良好的效果。

1 资料与方法

1.1 一般资料

选取2006年6月～2014年6月在本院泌尿外科就诊的老年前列腺增生症患者50例，年龄68～88岁，平均（76.15±4.52）岁，病程3～30年，平均（10.25±6.35）年。均合并一种或一种以上基础性疾病：高血压，冠心病，糖尿病，慢性梗阻性肺病，心脑血管意外等，其中心脏旁路移植术后6例，冠状动脉血管支架5例，心脏起搏器3例。……