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目的:探讨托特罗定治疗壁内段输尿管结石所致膀胱激惹症状的疗效。方法:选取2007年12月至2012年6月间共282例壁内段输尿管结石患者作为研究对象,并将其分为两组。A组为对照组,共140例,给予观察等待;B组为治疗组,共142例,给予托特罗定2 mg,每日2次,共2周。比较两组结石的排出率、排石时间、疼痛次数和止痛剂的应用等。患者每次排尿时应用排尿感觉量表(USS)进行记录,以表示尿急的发生率。应用视觉模拟量表(visual analog scale,VAS)疼痛评分来记录患者的疼痛程度。结果:A组和B组的结石排出率分别为56.4%和57.0%。两组平均肾绞痛发作次数分别为4.7和1.7。两组在第3天和第7天USS量表平均评分分别为2.76、1.32和1.90、1.18。两组间VAS评分亦有显著差异。结论:托特罗定对壁内段输尿管结石排石率并无提高,但它能减少此类患者的尿频、尿急症状,减轻疼痛的强度和不适感。
Objective: To investigate the efficacy of tolterodine in the treatment of bladder irritation caused by ureteral calculi in the wall segment. METHODS: A total of 282 patients with ureteral calculi in the wall segment between December 2007 and June 2012 were selected as the study subjects and divided into two groups. A group as the control group, a total of 140 cases, giving observation and waiting; B group for the treatment group, a total of 142 cases, given tolterodine 2 mg twice daily for 2 weeks. Comparison of the two groups of stone discharge rate, row of stone time, the number of pain and analgesic applications. The patient should record the urinary urgency scale (USS) for each urination to indicate the incidence of urgency. Visual acuity scale (VAS) pain scores were used to document the patient’s pain level. Results: The rates of stone excretion in groups A and B were 56.4% and 57.0%, respectively. The mean number of episodes of renal colic in the two groups was 4.7 and 1.7, respectively. The average score of USS was 2.76, 1.32 and 1.90, 1.18 on day 3 and day 7 in both groups. There was also a significant difference in VAS scores between the two groups. CONCLUSION: Tolterodine does not improve the rate of stone removal of ureteral stones in the in-wall segment, but it can reduce the frequent urination and urgency symptoms and relieve the pain intensity and discomfort in these patients.