坦索罗辛在输尿管下段结石体外冲击波碎石术后的排石作用(1)
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【摘要】目的:探讨坦索罗辛在输尿管下段结石体外冲击波碎石术后的排石效果。方法:256例输尿管下段结石患者随机分成两组,两组患者均进行体外冲击波碎石治疗。对照组:体外冲击波碎石治疗后应用双氯芬酸钠肠溶片50mg,2次/d,尿石痛丸4g,2次/d。实验组:体外冲击波碎石后,应用双氯芬酸钠肠溶片50mg,2次/d,尿石痛丸4g,2次/d,同时口服坦索罗辛0.4mg,1次/d。结果:治疗两周后,实验组排石成功率为78.91%,对照组为42.19%,实验组明显高于对照组,组间差异具有统计学意义(P<0.01)。实验组再次发生肾绞痛而需要镇痛治疗的患者占7.82%(10/128),低于对照组的15.62%(20/128),组间差异具有统计学意义(P<0.01)。实验组4例患者发生头晕但自然缓解外,无其他不良反应发生。结论:坦索罗辛可有效提高体外冲击波碎石治疗后的下段输尿管结石患者的排石成功率,减低术后肾绞痛的发生率,治疗安全有效,值得临床推广。
【关键词】输尿管下段结石;体外冲击波碎石术;坦索罗辛
doi:10.3969/j.issn.1006-1959.2010.09.271文章编号:1006-1959(2010)-09-2520-02
Tamsulosin enhances lower ureteral stone clearance with extracorporeal shockwave lithotripsyJIAO Zhi-yong
Department of Urology,Gaobu Hospital,Dongguan 523270,China
【Abstract】Objective: To evaluate the efficacy of α1-adrenergic antagonist in the management of lower ureteral stone with extracorporeal shockwave lithotripsy(ESWL).Methods:A total of 256 patients with stone located lower ureter were randomly divided into 2 groups,Group Ⅰ served as controls;Group Ⅱ received tamsulosin (0.4 mg,once daily) after ESWL.All patients were observed for 2 weeks.Results:During 2 weeks,expulsion of stone was in 54 cases (42.19%) of Group Ⅰ,in 101cases (78.91%) of Group Ⅱ.The difference in expulsion rates between Group Ⅰ and Group Ⅱ was statistically significant (P<0.01).In Group Ⅰ and Group Ⅱ,renal colic recurred within 2 weeks and analgesics were used in 20 cases (15.62%) and in 10cases (7.82%),with statistically significant (P<0.01).Conclusions:It is demonstrated that tamsulosin is safe and effective for adjunctive expulsive treatment for lower ureteral stone with ESWL.It can significantly improve the stone expulsion rate.
【Key words】Ureteral calculi;Lithotripsy;Tamsulosin
体外冲击波碎石术(extracorporeal shockwave lithotripsy,ESWL)具有操作简便、治疗费用低廉、对患者损伤小等优点,临床应用广泛。但是单纯ESWL治疗的疗效尚无法满足临床需求,临床研究表明,ESWL治疗后,联合应用排石药物,可有效提高结石患者的排石成功率。2008年7月～2010年6月我院采用α1肾上腺素能受体阻滞剂坦索罗辛辅助治疗ESWL术后患者128例,效果满意,现在报告如下:
1.资料与方法
1.1一般资料:本研究共收集病例256例,均为2008年7月～2010年6月笔者所在医院门诊或住院尿管下段结石患者,256例患者均经KUB、IVU检查确诊。
将256例患者随机分为实验组和对照组,各128例。实验组男81例,女47例,年龄22~59岁,平均年龄(43.3±11.0)岁,结石直径(8.2±5.7)mm。对照组男79例,女49例,年龄18~59岁,平均年龄(44 ......
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