目的 探討屈他維林聯(lián)合托特羅定治療經(jīng)尿道前列腺電切術(shù)后膀胱痙攣的臨床療效。方法 選取2016年6月—2017年6月在河北省滄州中西醫(yī)結(jié)合醫(yī)院治療的經(jīng)尿道前列腺電切術(shù)后后膀胱痙攣患者82例，隨機(jī)將患者分為對照組（41例）和治療組（41例）。對照組口服酒石酸托特羅定片，2 mg/次，2次/d。治療組在對照組基礎(chǔ)上口服鹽酸屈他維林片，80 mg/次，3次/d。兩組均在拔出尿管3 d后停藥。觀察兩組患者臨床療效，比較治療前后兩組患者膀胱痙攣次數(shù)和持續(xù)時(shí)間以及膀胱過度活動癥評分（OABSS）評分、膀胱狀況感知量表（PPBC）評分、視覺模擬評分法（VAS）評分和生活質(zhì)量（QOL）評分。結(jié)果 治療后，對照組和治療組臨床有效率分別為80.49%和97.56%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）。治療2、3 d后，兩組膀胱痙攣次數(shù)和持續(xù)時(shí)間均較治療前顯著減少，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）；治療后，治療組膀胱痙攣次數(shù)和持續(xù)時(shí)間比同時(shí)期對照組均顯著減少，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）。治療后，兩組患者OABSS評分、PPBC評分、VAS評分和QOL評分均明顯降低；同組比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）；且治療組上述相關(guān)評分明顯低于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）。結(jié)論 屈他維林聯(lián)合托特羅定治療經(jīng)尿道前列腺電切術(shù)后膀胱痙攣可顯著改善患者臨床癥狀，減輕患者疼痛，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical curative effect of drotaverine combined with tolterodine in treatment of bladder spasm after trans-urethral resection of prostate. Methods Patients (82 cases) with bladder spasm after trans-urethral resection of prostate in Cangzhou Hospital of Integrated TCM-WM∙Hebei from June 2016 to June 2017 were randomly divided into control (41 cases) and treatment (41 cases) groups. Patients in the control group were po administered with Tolterodine Tartrate Tablets, 2 mg/time, twice daily. Patients in the treatment group were po administered with Drotaverine Hydrochloride Tablets on the basis of the control group, 80 mg/time, three times daily. Patients in two groups were treated until pulling out the urethral catheter for 3 d. After treatment, the clinical efficacy was evaluated, the frequency and duration of bladder spasm, the OABSS, PPBC, VAS, and QOL scores in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 80.49% and 97.56%, respectively, and there were differences between two groups (P < 0.05). After treatment for 2 and 3 d, the frequency and duration of bladder spasm in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the frequency and duration of bladder spasm in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the OABSS, PPBC, VAS and QOL scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And these scores in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Drotaverine combined with tolterodine in treatment of bladder spasm after trans-urethral resection of prostate can improve clinical symptoms and relieve the pain of patients, which has a certain clinical application value.