坦索罗辛预防肾结石ESWL术后并发症的临床研究

Efficacy of tamsulosin in the prevention of complication after extracorporeal shock wave lithotripsy for renal calculi

目的探讨坦索罗辛对肾结石体外冲击波碎石(ESWL)术后排石的疗效及对并发症的预防作用。方法120例单纯肾结石行ESWL术患者,结石直径8-22 mm,随机分成2组,坦索罗辛组60例,给予氟罗沙星、排石冲剂及坦索罗辛(哈乐),对照组60例,给予氟罗沙星、排石冲剂,治疗时间4周,比较2组之间结石排净率、石街的形成、疼痛评分(VAS)、膀胱刺激症状。结果坦索罗辛组的结石排净率(88.3%)高于对照组(71.7%)(P=0.022),坦索罗辛组石街形成率(6.7%)低于对照组(16.7%)(P=0.040),坦索罗辛组疼痛VAS评分[2(0-7)分]低于对照组[4(0-8)分(P<0.01)],坦索罗辛组膀胱刺激症状发生率(10%)低于对照组(21.7%)(P=0.024)。治疗期间2组未出现药物不良反应。结论ESWL术后坦索罗辛能够促进ESWL术后结石排出,预防石街形成,缓解疼痛及膀胱刺激症状,可以作为肾结石ESWL术后排石的辅助用药。

Objective To investigate the efficacy of tamsulosin in facilitating stone expulsion and avoiding complication after extracorporeal shock wave lithotripsy （ESWL）. Methods A total of 120 patients who were to receive ESWL for a single renal calculus （8 to 22 mm）, were randomly divided into 2 groups. 60 patients in the tamsulosin group received tamsulosin, fleroxacin and traditional herbal medicine and the other, 60 patients in the control group received fleroxacin and traditional herbal medicine. Differences of stone clearance rate, steinstrasse, visual analog scale （VAS） and irritative bladder symptoms between the 2 groups were compared. All patients were observed for 4 weeks. Results The stone clearance rate was significantly increased in the tamsulosin group compared to the control group （88.3 % vs. 71.7 %）. Cases of steinstrasse and irritative bladder symptoms in the tamsulosin group were significantly decreased compared to the control group （6.7% vs. 16.7%; 10.0% vs. 21.7%）, respectively. Visual analog scale （VAS） of patients in the tamsulosin group was decreased compared to the control group （median 2, ranging from 0 to 7 vs. median 4, range from 0 to 8）. No obvious side effects occurred during treatment. Conclusion Use of tamsulosin can facilitate stone clearance after ESWL for renal calculi. It also seems to be beneficial in terms of the reduced number of steinstrasse and the severity of pain in the patients. Tamsulosin can be an assistant-drug in facilitating the expulsion of the fragments after ESWL for renal calculi.