目的 探討間苯三酚聯(lián)合托特羅定預(yù)防下尿路微創(chuàng)術(shù)后膀胱痙攣的臨床療效。方法 選取2014年1月-2016年1月涿州市醫(yī)院泌尿外科收治的下尿路微創(chuàng)手術(shù)患者128例，隨機(jī)分為對(duì)照組和治療組，每組各64例。對(duì)照組術(shù)后口服酒石酸托特羅定緩釋片，2 mg/次，2次/d。治療組在對(duì)照組基礎(chǔ)上肌肉注射間苯三酚注射液，40 mg/次，2次/d。兩組患者均治療至停留置導(dǎo)尿后1 d。比較兩組的VAS評(píng)分、膀胱痙攣次數(shù)、痙攣持續(xù)時(shí)間、膀胱沖洗轉(zhuǎn)清時(shí)間和尿管拔除時(shí)間情況。結(jié)果 術(shù)后0~24、24~48、48~72 h，治療組膀胱痙攣次數(shù)均顯著少于同期對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。術(shù)后0~24、24~48、48~72 h，治療組膀胱痙攣持續(xù)時(shí)間均顯著短于同期對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，治療組膀胱沖洗轉(zhuǎn)清時(shí)間和尿管拔出時(shí)間均顯著短于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組VAS評(píng)分均顯著下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組VAS評(píng)分的下降程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 間苯三酚聯(lián)合托特羅定預(yù)防下尿路微創(chuàng)術(shù)后膀胱痙攣具有較好的臨床療效，可改善臨床癥狀，縮短膀胱沖洗轉(zhuǎn)清和尿管拔出時(shí)間，安全性好，具有一定的臨床推廣應(yīng)用價(jià)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.

保定市科學(xué)技術(shù)研究與發(fā)展指導(dǎo)計(jì)劃項(xiàng)目（15ZF063）