膀胱不同部位注射A型肉毒素治疗女性难治性膀胱过度活动症的临床研究

目的：观察膀胱不同部位注射A型肉毒素治疗女性难治性膀胱过度活动症的疗效。方法40例入选病例，随机分为逼尿肌注射组（A组）、逼尿肌联合三角区注射组（B组），评估患者治疗前及治疗后4周的临床症状（平均每日日间排尿次数、平均每次排尿量、夜尿次数、尿急次数）及尿动力学指标（初始尿意膀胱容量、最大膀胱容量）和 OABSS 评分、QOL 评分情况。结果经过A型肉毒素注射治疗4周后，A组平均每日日间排尿次数、平均每次排尿量、夜尿次数、尿急次数以及OABSS评分， QOL评分、最大膀胱容量均较B组有明显改善（P＜0．05）。结论 A型肉毒素膀胱内注射治疗难治性膀胱过度活动症疗效好，无明显毒副作用，是治疗难治性膀胱过度活动的经济、有效的新方法；采用逼尿肌联合三角区部位的注射，症状缓解更为明显，值得进一步的研究及推广。

Clinical study of botulinum toxin type A injection on different positions of the bladder in female overactive bladder

Objective To observe the different effects caused by different injection sites in bladder ,in cases of female overac‐tive bladder cured by botulinum toxin type A injection .Methods Forty cases were divided into 2 groups randomly .Cases of group A accepted botulinum toxin type A injection only on detrusor .Cases of group B accepted botulinum toxin type A injection on detru‐sor and trigone of urinary bladder .The following parameters were recorded to evaluate the effects 4 weeks later :average daytime u‐rination frequency ,urination frequency at night ,average quantity of each urination ,frequency of urgency ,bladder capacity at first de‐sire ,maxima bladder capacity ,OABSS scores and QOL scores .Results After 4‐week treatment with botulinum toxin type A ,all pa‐rameters ,average daytime urination frequency ,urination frequency at night ,average quantity of each urination ,frequency of urgen‐cy ,bladder capacity at first desire ,maxima bladder capacity ,OABSS scores and QOL scores in cases of group A had a better im‐provment than those of cases of group B .Conclusion Botulinum toxin type A injection on bladder is a new effective method for fe‐male refractory overactive bladder .Injection on detrusor and trigone of urinary bladder is better than injection only on detrusor .