[1]章杰城,林宜淋,赖传进,等.米拉贝隆联合索利那新防治前列腺电切术后导尿管相关膀胱刺激症的疗效分析[J].福建医药杂志,2024,46(01):12-17.[doi:10.20148/j.fmj.2024.01.004]
　ZHANG Jiecheng,LIN Yilin,LAI Chuanjin,et al.Efficacy and safety of mirabegron combined with solifenacin for catheter related bladder discomfort in patients undergoing transurethral resection of the prostate：A prospective case-control study[J].FUJIAN MEDICAL JOURNAL,2024,46(01):12-17.[doi:10.20148/j.fmj.2024.01.004]
点击复制

米拉贝隆联合索利那新防治前列腺电切术后导尿管相关膀胱刺激症的疗效分析()
分享到：

《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
46
期数:
2024年01期
页码:
12-17
栏目:
临床研究
出版日期:
2024-02-15

文章信息/Info

Title:
Efficacy and safety of mirabegron combined with solifenacin for catheter related bladder discomfort in patients undergoing transurethral resection of the prostate：A prospective case-control study
文章编号:
1002-2600（2024）01-0012-06
作者:
章杰城; 林宜淋; 赖传进; 童明烨; 吕金星; 张金墩; 郭国建; 李松川; 苏宏树
福建省德化县医院泌尿外科，泉州 362500；Email：424031867@qq.com
Author(s):
ZHANG Jiecheng;  LIN Yilin;  LAI Chuanjin;  TONG Mingye;  LV Jinxing;  ZHANG Jindun;  GUO Guojian;  LI Songchuan;  SU Hongshu
Department of Urology, Dehua County Hospital, Quanzhou, Fujian 362500, China
关键词:
米拉贝隆; 索利那新; 前列腺电切; 导尿管相关膀胱刺激征; β3肾上腺受体激动剂; 静脉给药量; M受体拮抗剂
Keywords:
mirabegron;  solifenacin;  transurethral resection of the prostate ;  catheter related bladder discomfort; β3 adrenoceptor agonist;  amount of intravenous fluids;  muscarinic receptor antagonists
分类号:
R699.6
DOI:
10.20148/j.fmj.2024.01.004
文献标志码:
A
摘要:
目的论证米拉贝隆联合索利那新防治经尿道前列腺电切术(TURP)术后导尿管相关膀胱刺激症(CRBD)的有效性和安全性。方法将符合标准的108例接受TURP手术的前列腺增生患者随机分为三组，每组36例；术前1天开始M+S组给予口服米拉贝隆50 mg/d联合索利那新5 mg/d；S组服用单药索利那新5 mg/d；C组仅接受TURP手术。对术后出现中度以上CRBD的患者进行自制综合量表评分，达到设定标准的予静脉滴注间苯三酚处理。观察各组术后第1、3、5天CRBD发生情况，术后5天内静脉给药量，持续膀胱冲洗时间及药物不良反应。结果共有106例患者纳入最终的分析，M+S组除了术后第1天在中度和重度CRBD的发生率上与S组相当外，在其他时间节点的CRBD总发生率、中度和重度CRBD发生率及静脉给药量上均明显优于S组及C组（P＜0.05）；S组与C组相比在任何时间节点均没有降低CRBD总发生率（P＞0.05），但在中度和重度CRBD的发生率及静脉用药量上优于C组（P＜0.05）。3组术前及术后第1、3、5天的心率、收缩压、舒张压值均无统计学意义（P＞0.05）；M+S组和S组中新发口干、便秘的例数略多于C组，但是差异无统计学意义（P＞0.05）；M+S组额外报告1例新发皮疹。结论米拉贝隆联合索利那新可降低TURP术后CRBD的发生率，减少患者静脉解痉药物的应用，较单药索利那新效果更优且不增加药物不良反应。
Abstract:
ObjectiveTo investigate the safety and efficacy of mirabegron combined with solifenacin in the treatment of CRBD after TURP. MethodsA total of 108 patients with BPH who underwent TURP were randomly divided into three groups, 36 cases in each group. Patients in M+S group were given oral mirabegron 50 mg/d combined with solifenacin 5 mg/d from one day before surgery; S group was given solifenacin 5 mg/d; C group received surgical treatment only. Patients with more than moderate degree of CRBD after operation were scored, and those who met the indications were given intravenous spasmodic and analgesic treatment. The occurrence of CRBD in each group at the 1st, 3rd and 5th day after surgery and the amount of intravenous fluids within the 5th day after surgery were recorded, the time of continuous catheter washout and adverse drug reactions were also recorded. ResultsA total of 106 patients were included in the final analysis. On postoperative day 1, the probability of more than moderate CRBD was not significantly different between the M+S and S groups（P＞0.05）, in addition, the incidence of overall CRBD, the incidence of more than moderate CRBD, and the amount of intravenous fluids in the M+S group were significantly less than those in the S and C groups at any time point(P<0.05). Compared with C group, S group did not reduce the overall incidence of CRBD(P>0.05), but the incidence of CRBD above moderate degree and the amount of intravenous infusion were better than those in C group(P<0.05). There was no difference in heart rate, systolic blood pressure and diastolic blood pressure between the three groups before surgery and 1, 3 and 5 days after surgery(P>0.05). There was no difference in the incidence of dry mouth, constipation, too(P>0.05). One additional case of rash was reported in the M+S group. ConclusionMirabegron combined with solifenacin can reduce the incidence of CRBD after TURP, reduce the intravenous use of spasmolytics， and has a more significant effect than solifenacin alone without increasing adverse drug reactions.

参考文献/References:

[1] CHUNG J M,HA H K,KIM D H,et al.Evaluation of the efficacy of solifenacin for preventing catheter-related bladder discomfort after transurethral resection of bladder tumors in patients with non-muscle invasive bladder cancer：A prospective,randomized,multicenter study[J].Clin Genitourin Cancer,2017,15(1):157-162.
[2] ZHANG Z,CAO Z,XU C,et al.Solifenacin is able to improve the irritative symptoms after transurethral resection of bladder tumors[J].Urology,2014,84(1):117-121.
[3] WANG J P,ZHOU Z B,CUI Y S,et al.Meta-analysis of the efficacy and safety of mirabegron and solifenacin monotherapy for overactive bladder[J].Neurourol Urodyn,2019,38(1):22-30.
[4] GRATZKE C,VAN MAANEN R,CHAPPLE C,et al.Long-term safety and efficacy of mirabegron and solifenacin in combination compared with monotherapy in patients with overactive bladder：A randomised,multicentre phase 3 study(SYNERGY Ⅱ)[J].Eur Urol,2018,74(4):501-509.
[5] KELLEHER C,HAKIMI Z,ZUR R,et al. Efficacy and tolerability of mirabegron compared with antimuscarinic mono-therapy or combination therapies for overactive bladder：A systematic review and network Meta-analysis[J].Eur Urol,2018,74(3):324-333.
[6] YAMANISHI T,CHAPPLE C R,CHESS-WILLIAMS R.
Which muscarinic receptor is important in the bladder?[J].World J Urol,2001,19(5):299-306.
[7] REN J,YU T,TIAN Y,et al.Comparative effectiveness of interventions for managing urological postoperative catheter-related bladder discomfort：a systematic review and network meta-analysis[J].BMC Urol,2023,23(1):29.
[8] LI S,LI P,WANG R,et al.Different interventions for preventing postoperative catheter-related bladder discomfort：a systematic review and meta-analysis[J].Eur J Clin Pharmacol,2022,78(6):897-906.
[9] JANG E B,HONG S H,KIM K S,et al.Catheter-related bladder discomfort：how can we manage it?[J].Int Neurourol J,2020,24(4):324-331.
[10] AGARWAL A,DHIRAAJ S,SINGHAL V,et al.Compa-rison of efficacy of oxybutynin and tolterodine for prevention of catheter related bladder discomfort：a prospective,randomized,placebo-controlled,double-blind study[J].Br J Anaesth,2006,96(3):377-380.
[11] PENG X F,LV X G,XIE H,et al.Effectiveness of solifenacin for managing of bladder spasms in patients with urethroplasty[J].Am J Mens Health,2017,11(5):1580-1587.
[12] IN C B,LEE S J,SUNG T Y,et al.Effects of chlorpheniramine maleate on catheter-related bladder discomfort in patients undergoing ureteroscopic stone removal：a randomized double-blind study[J].Int J Med Sci,2021,18(4):1075-1081.
[13] SRIVASTAVA V K,AGRAWAL S,KADIYALA V N,et al.The efficacy of pregabalin for prevention of catheter-related bladder discomfort：a prospective,randomized,placebo-controlled double-blind study[J].J Anesth,2015,29(2):212-216.
[14] CHEON Y W,KIM S H,PAEK J H,et al.Effects of nefopam on catheter-related bladder discomfort in patients undergoing ureteroscopic litholapaxy[J].Korean J Anesthesiol,2018,71(3):201-206.
[15] LI S Y,LI H,NI J,et al.Comparison of intravenous lidocaine and dexmedetomidine infusion for prevention of postoperative catheter-related bladder discomfort：a randomized controlled trial[J].BMC Anesthesiol,2019,19(1):37.
[16] KENNELLY M J,RHODES T,GIRMAN C J,et al.efficacy of vibegron and mirabegron for overactive bladder：a systematic literature review and indirect treatment comparison [J].Adv Ther,2021,38(11):5452-5464.
[17] DEEKS E D.MIRABEGRON：a review in overactive bladder syndrome[J].Drugs,2018,78(8):833-844.
[18] FAN B,SHEN J,WU L,et al.Study of mirabegron and solifenacin in the improvement of catheter-related bladder discomfort in patients undergoing transurethral resection：a case-control study[J].Medicine(Baltimore),2022,101(48):e32052.
[19] 陈铁定,王荫槐,杨罗艳,等.间苯三酚预防前列腺电切术后膀胱痉挛的疗效分析[J].中华男科学杂志,2010,16(11):1004-1006.
[20] MUELLER E R,VAN MAANEN R,CHAPPLE C,et al.Long-term treatment of older patients with overactive bladder using a combination of mirabegron and solifenacin：a prespecified analysis from the randomized,phase Ⅲ SYNERGY Ⅱ study[J].Neurourol Urodyn,2019,38(2):779-792.

备注/Memo

备注/Memo:
基金项目：福建省泉州市科技计划项目医学与临床科研项目（NO.2020N087s）
通信作者：苏宏树，主任医师，Email：1838734668@qq.com
更新日期/Last Update: 2024-02-15