坦索罗辛缓释胶囊、双氯芬酸钠、硝苯地平三联在输尿管下段结石ESWL后辅助排石中的作用

The Medical Expulsive Effect of Tamsulosin, Diclofenac, Nifedipine Triple in the Lower Ureteral Calculi after ESWL

目的研究α1肾上腺素能受体阻滞剂坦索罗辛、非甾体类镇痛抗炎药双氯芬酸钠和钙离子阻滞剂硝苯地平三联药物在输尿管下段结石ESWL后辅助排石中的效果。方法98例输尿管下段结石患者随机分成两组院组1为对照组,于ESWL后口服坦索罗辛缓释胶囊0.4 mg,1次/晨;组2于ESWL后口服坦索罗辛缓释胶囊0.4 mg,1次/晨,双氯芬酸钠缓释胶囊50 mg,2次/d,硝苯地平缓释片10 mg,2次/d。每例患者观察时间不超过2 w。结果在观察时间内组1、组2排石率分别为73.5%和91.8%,结石排出时间分别为8 d和5 d,再次发生肾绞痛而需要镇痛药治疗的患者分别为20.4%和4.1%,两组排石率、排石时间及肾绞痛发生率比较差异均有统计学意义(<0.05)。组2除1例发生低血压外,无其他不良反应发生。结论坦索罗辛缓释胶囊、双氯芬酸钠和硝苯地平三联药物能提高输尿管下段结石ESWL后的排石率、缩短排石时间和减少再发生肾绞痛的机率,且安全有效,可作为输尿管下段结石ESWL后的辅助排石方法。

Objective To study the adjunctive expulsive effect of a1 adrenergic receptor blocker tamsulosin,non steroidal anti-inflammatory drug diclofenac sodium and calcium channel blockers nifedipine in the lower ureteral calculi after ESWL.Methods 98 cases of lower ureteral calculi patients were randomly divided into 2 groups:the patients in group 1 took tamsulosin(0.4mg,1/early morning)after ESWL;the patients in group 2 took tamsulosin(0.4mg,1/early morning),diclofenac sodium sustained release capsules(50mg,2/day)and extended release nifedipine tablets(10mg,2/day).Al patients were observed for less than 2 weeks.Results During the period of observation,the lithagogue rate of group 1 and group 2 were 73.5%and 91.8%,respectively.The stone expulsion time of group 1 was 9.3±2.6d and group 2 was 6.6±2.1d.The patients in two groups who had renal colic post-ESWL and needed analgesic drug treated were respectively 20.4%and 4.1%.There were significant differences between group 1 and group 2 in lithagogue rate,expulsion time and recurrenced renal colic.In group 2,there was one patient got hypotension during the combine treatment.Conclusion The combine therapy of tamsulosin,diclofenac sodium and nifedipine can improve the stone expulsion rate of the lower ureteral calculi after ESWL,shorten lithagogue time and reduce the possibility of renal colic post-ESWL.In our present study,we proved the combine treatment is ef ective and safe,can be used as an auxiliary therapy for lower ureteral calculi after ESWL.