夏雨果++++++陈秋++++++梅雪峰++++++曾文彤++++++田英++++++赵娟++++++曾政光++++++熊国兵++++++尹静

[摘要]目的 评价坦索罗辛联合溴吡斯的明治疗前列腺增生伴尿潴留的临床效果。方法 收集2013年1月～2016年12月以上四家医院前列腺增生伴尿潴留患者60例，进行为期6周的治疗。随机分成A、B两组，A组（n=30）单用坦索罗辛（0.2 mg，每晚），B组（n=30）联合服用坦索罗辛（0.2 mg，每晚）和溴吡斯的明（60 mg，3次/d），两组患者均留置尿管1周。两组分别在治疗前后以国际前列腺症状评分（IPSS）、生活质量评估（QOL）、膀胱过度活动症评分（OABSS）、最大尿流率（Qmax）以及残余尿量（RV）为评估指标，比较两组治疗前后的上述指标以及治疗效果。结果 治疗6周后，可评价病例52例，A组25例，B组27例；与治疗前比较，两组治疗后的IPSS评分、QOL评分、Qmax、RV均得到显著改善（P<0.01）；A组治疗前后的OABSS评分差异有统计学意义（P<0.05），B组治疗前后的OABSS评分差异有统计学意义（P<0.01）。B组治疗后的IPSS评分、Qmax、RV明显优于A组（P<0.05），而两组治疗后的QOL、OABSS评分比较差异无统计学意义（P>0.05）。结论 坦索罗辛联合溴吡斯的明比单用坦索罗辛更能有效地治疗前列腺增生引起的尿潴留，并不明显增加患者膀胱过度活动症状，具有较好临床运用价值。

[关键词]前列腺增生；尿潴留；膀胱过度活动症；坦索罗辛；溴吡斯的明

[中图分类号] R694+.55 [文献标识码] A [文章编号] 1674-4721（2017）03（c）-0116-03

[Abstract]Objective To evaluate clinical efficacy of Tamsulosin combined with Pyridostigmine Bromide treating benign prostatic hyperplasia （BPH） complicated with urinary retention.Methods Totally 60 cases of clinically diagnosed BPH with urinary retention from January 2013 to December 2016 were selected and were randomly assigned to group A （n=30） receiving 0.2 mg of Tamsulosin once a day and group B （n=30） receiving 0.2 mg of Tamsulosin once a day plus 30 mg of Pyridostigmine Bromide，3 times a day for 6 weeks，and patients of two groups were indwelled catheter for one week.Before and after the treatment，IPSS，QOL，OABSS，Qmax and RV were recorded and evaluated.IPSS，QOL，OABSS，Qmax and RV before and after the treatment and treatment effect between two groups were compared.Results After 6 weeks medication，the assessable cases were 52 cases including 25 cases in group A and 27 cases in group B.Score of IPSS，QOL and Qmax，RV were improved significantly in both groups （P<0.01）.Besides，OABSS score was also statistical difference in group A （P<0.05） and group B （P<0.01） before and after treatment.However，IPSS，Qmax and RV in group B were significantly improved than those in the group A （P<0.05）.There was no significant difference in QOL，OABSS score between two groups （P>0.05）.Conclusion Combination therapy with Tamsulosin and Pyridostigmine Bromide is more effective in the treatment of BPH with urinary retention，and it does not significantly increase OAB symptoms，having good clinical application value.

[Key words]Benign prostatic hyperplasia；Urinary retention；Overactive bladder；Tamsulosin；Pyridostigmine Bromide

尿潴留是泌尿外科常見疾病，表现为膀胱内充满尿液而不能自主排出，其中很大一部分是由前列腺增生（benign prostatic hyperplasia，BPH）引起，具有解剖学上的膀胱出口梗阻（bladder outlet obstruction，BOO）以及以下尿路症状（lower urinary tract symptoms，LUTS），上述症状加重到一定程度可引起慢性尿潴留，损害膀胱功能[1]。BPH伴尿潴留是该类患者的手术指征，但部分患者拒绝手术治疗，或者愿意手术，但由于有手术禁忌证或心肺功能较差而放弃手术，因此药物治疗成为此类患者重要的手段。……