坦索罗辛在输尿管下段结石ESWL后辅助排石中的作用

Tamsulosin enhances lower ureteral stone clearance with extracorporeal shock wave lithotripsy

目的:探讨α1肾上腺素能受体阻滞剂坦索罗辛在输尿管下段结石ESWL后辅助排石中的效果。方法:64例输尿管下段结石患者随机分成两组,组Ⅰ为对照组,ESWL后应用消炎痛25mg,3次/d,排石颗粒5g,3次/d,未应用输尿管平滑肌松弛剂;组Ⅱ为实验组,ESWL后在对照组治疗方案基础上予以口服坦索罗辛0.4mg,1次/d。每例患者观察时间不超过2周。结果:在观察时间内两组排石率分别为42.3%和78.9%,两组比较差异有统计学意义(P<0.01)。观察时间内两组再次发生肾绞痛而需要镇痛药治疗的患者分别为15.4%和7.9%,两组比较差异有统计学意义(P<0.01)。组Ⅱ除1例发生头晕外,无其他不良反应发生。结论:坦索罗辛能提高输尿管下段结石ESWL后的排石率,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ES-WL后的辅助排石方法。

Objective：To evaluate the efficacy of α1-adrenergic antagonist in the medical management of lower ureteral stone with ESWL. Methods：A total of 64 patients with stone located lower ureter were randomly divided into 2 groups, Group 1 served as controls; group 2 received tamsulosin （0. 4mg, once daily ） after ESWL. All patients were observed for 2 weeks. Results：During 2 weeks, expulsion of stone was in 11 cases （ 42. 3 %） of group 1, in 30 cases （78.9 % ） of group 2. The difference in expulsion rates between group 1 and group 2 was statistically significant （P〈0. 01）. In group 1 and group 2, renal colic recurred within 2 weeks and analgesics were used in 4 cases （ 15.40% ） and in 3 cases （7.9 % ） 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.