- 期刊
Comparison of the Therapeutic Effects of Urethral Injecteons of 50 and 100 Units of Botulinum A Toxin for Voiding Dysfunction
尿道內注射肉毒桿菌素A治療排尿障礙－比較50及100單位之療效
摘要
目的：尿道內肉毒桿菌素A(BoNT-A)對於排尿功能障礙具有治療的效果。然而至今並無最適當劑量的相關研究，本研究比較使用50U及100U BOTOX之療效，以作為臨床用藥之參考。 材料及方法：總共66位具有排尿障礙的病人隨機接受尿道內注射50U(n=33)或100U(n=33)BOTOX治療，針對這兩組病人治療效果及尿動力學檢查進行比較。 結果：整體治療結果顯示具有極佳效果的病人在100U及50U兩組分別為20(60.6%)位及23(69.7%)位具有進步效果者有10(30.3%)位及5(15.2%)位，治療失敗者為3(9%)位及5(15.2%)位兩組病人在治療後的排尿壓力、尿後殘尿、最大尿道閉鎖壓力有意義的降低生活品質指數及最大尿流速則有意義的增加。治療前後的改變，在兩組問並無有意義的差別。對於逼尿肌無收縮的病人而言，50U及100治療後68%及33%具有極佳的療效，而對於尿道外括約肌張力過強的病人，療效分別為71.4%及70.8%。不過100U治療的病人比50U治療的病人有較長的療效（8.4±3.4月比6.4±3.5月，p=0.022）。 結論：尿道內注射50U BOTOX與注射100U在治療任何原因造成的排尿障礙具有相同的療效。但50U治療後療效時間較短。
並列摘要
Objectives: Urethral injection of botulinum A toxin (BoNT-A) has therapeutic effects on voiding dysfunction. However, the optimal dose remains to be determined. This study compared the therapeutic results of urethral injections of 50U and 100U of BoNT-A. Materials and Methods: Sixty-six patients with voiding dysfunction were randomly treated with urethral injections of 50U (n=33) or 100U (n=33) of BoNT-A (BOTOX). The therapeutic results and changes in the urodynamic parameters were compared between these two groups of patients. Results: The overall therapeutic results in the 100U and 50U injection groups were excellent in 20 (60.6%) and 23 (69.7%) patients, improved in 10 (30.3%) and 5(15.2%), and failed in 3(9%) and 5(15.2%), respectively. Significant reductions in the voiding pressure, postvoid residual volume, and maximal urethral closure pressure as well as improvement in the quality of life index and increases in the maximum flow rate were noted after treatment in both groups. No significant between-group differences were noted in the net changes of the urodynamic parameters after treatment. Excellent results were noted in 68% and 33% of patients with detrusor underactivity, and in 71.4% and 70.8% of patients with hyperactive urethral sphincter who received injections of 50U and 100U, respectively. The mean durations of therapeutic effect were 6.4±3.6 months and 8.4±3.4 months in the 50U and 100U groups, respectively (p=0.022). Conclusion: Urethral injection of 50U of BOTOX is as effective as 100U in the treatment of voiding dysfunction of any etiology, but the duration of therapeutic effect was significantly shorter in the group who received 50U.