3下尿路征候群藥物應(yīng)用

1、第二軍醫(yī)大學(xué)長征醫(yī)院泌尿外科第二軍醫(yī)大學(xué)長征醫(yī)院泌尿外科瞿創(chuàng)予瞿創(chuàng)予 任吉忠任吉忠貯尿期表現(xiàn)貯尿期表現(xiàn)排尿期表現(xiàn)排尿期表現(xiàn)排尿排尿躊躇躊躇尿中斷尿中斷尿線細(xì)尿線細(xì)尿不盡尿不盡尿淋漓尿淋漓尿潴留尿潴留貯尿期癥狀原因貯尿期癥狀原因膀胱原因膀胱原因尿道原因尿道原因膀胱過動(dòng)癥膀胱過動(dòng)癥感覺性尿急迫感覺性尿急迫低順應(yīng)性低順應(yīng)性過度移動(dòng)過度移動(dòng)括約肌乏力括約肌乏力排尿期癥狀原因排尿期癥狀原因膀胱功能異常膀胱功能異常尿道或括約肌功能異常尿道或括約肌功能異常收縮無力收縮無力梗阻梗阻 。 圖1 圖2 kaplan sa, roehrborn cg, rovner es, et al. tolterodine a

2、nd tamsulosin for treatment of men with lower urinary tract symptoms and overactive bladder: a randomized controlled trial. jama 2006, 296: 23192328.antimuscarinic agents tolterodine (detrol la) oxybutynin (ditropan xl, oxytrol patch) trospium (sanctura ) solifenacin (vesicare) darifenacin (enablex)

3、botulinum toxin potent neurotoxin (1 gm in aerosol form could kill 1,000,000 people) has been used mostly in neurogenic patients primarily to treat neurogenic detrusor overactivity, bph neurogenic patients with dsd several subtypes (btx-a & btx-b) available. resistance has been reported。 五、五、mrmr阻滯劑之應(yīng)用阻滯劑之應(yīng)用 五、五、mrmr阻滯劑之應(yīng)用阻滯劑之應(yīng)用 前列腺增前列腺增生患者貯生患者貯尿期逼尿尿期逼尿肌穩(wěn)定，肌穩(wěn)定，排尿期逼排尿期逼尿肌有反尿肌有反射伴外括射伴外括約肌協(xié)調(diào)，約肌協(xié)調(diào)，tltl值值1.641.64 尿頻、排尿頻、排尿困難診尿困難診斷失調(diào)性斷失調(diào)性排尿女性排尿女性2222歲患者歲患者貯尿期逼貯尿期逼尿肌穩(wěn)定，