目的 探讨间苯三酚联合托特罗定预防下尿路微创术后膀胱痉挛的临床疗效。方法 选取2014年1月-2016年1月涿州市医院泌尿外科收治的下尿路微创手术患者128例，随机分为对照组和治疗组，每组各64例。对照组术后口服酒石酸托特罗定缓释片，2 mg/次，2次/d。治疗组在对照组基础上肌肉注射间苯三酚注射液，40 mg/次，2次/d。两组患者均治疗至停留置导尿后1 d。比较两组的VAS评分、膀胱痉挛次数、痉挛持续时间、膀胱冲洗转清时间和尿管拔除时间情况。结果 术后0~24、24~48、48~72 h，治疗组膀胱痉挛次数均显著少于同期对照组，两组比较差异有统计学意义（P<0.05）。术后0~24、24~48、48~72 h，治疗组膀胱痉挛持续时间均显著短于同期对照组，两组比较差异有统计学意义（P<0.05）。治疗后，治疗组膀胱冲洗转清时间和尿管拔出时间均显著短于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组VAS评分均显著下降，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组VAS评分的下降程度明显优于对照组，两组比较差异具有统计学意义（P<0.05）。结论 间苯三酚联合托特罗定预防下尿路微创术后膀胱痉挛具有较好的临床疗效，可改善临床症状，缩短膀胱冲洗转清和尿管拔出时间，安全性好，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of phloroglucinol combined with tolterodine in treatment of bladder spasm after minimally invasive surgery of lower urinary tract. Methods Patients (128 cases) with minimally invasive surgery of lower urinary tract in Department of Urology of Zhuozhou City Hospital from January 2014 to February 2016 were randomly divided into control and treatment groups, and each group had 64 cases. Patients in the control group were po administered with Tolterodine Tartrate Sustained Release Tablets after surgery, 2 mg/time, twice daily. Patients in the treatment group were im administered with Phloroglucinol Injection on the basis of the control group, 40 mg/time, twice daily. Patients in two groups were treated until 1 d after stopping indwelling catheterization. After treatment, VAS scores, spasm frequency and duration of spasm of bladder, the times of bladder flushing liquid transfer cleaning, and catheter removal in two groups were compared. Results After treatment, the VAS scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After surgery for 0-24 h, 24-48 h, and 48-72 h, the frequency and duration of bladder spasm in the treatment group were significantly less than those in the control group, and there was difference between two groups (P<0.05). After treatment, the times of bladder flushing liquid transfer cleaning and catheter removal in the treatment group were significantly shorter than those in the control group, and there was difference between two groups (P<0.05). Conclusion Phloroglucinol combined with tolterodine has clinical prophylactic effect in treatment of bladder spasm after minimally invasive surgery of lower urinary tract, can improve clinical symptoms, shorten the times of bladder flushing liquid transfer cleaning and catheter removal, with good safety, which has a certain clinical application value.

保定市科学技术研究与发展指导计划项目（15ZF063）