坦索罗辛和山莨菪碱对输尿管下段结石体外冲击波碎石(ESWL)术后辅助排石的疗效比较

Comparison of tamsulosin and anisodamine in the management of lower ureteral stones after extracorporeal shock wave lithotripsy(ESWL)

目的分析比较坦索罗辛和山莨菪碱在输尿管下段结石体外冲击波碎石术后辅助排石的疗效。方法90例输尿管下段结石患者随机分3组,每组30例,结石直径0.4-1.0 cm。对照组未给予输尿管平滑肌松弛剂;山莨菪碱组给予山莨菪碱10 mg,3次/d;坦索罗辛组给予坦索罗辛0.4 mg,1次/d。每例患者治疗观察期不超过2周。结果2周内结石排出者对照组为27例(86.7%),山莨菪碱组为28例(93.3%),坦索罗辛组为28例(93.3%)。各组比较排石率无显著差异(P>0.05)。各组平均排石时间分别为(5.6±4.0)d、(5.2±2.8)d、(4.6±2.7)d,山莨菪碱组、坦索罗辛组较对照组时间短,差异有统计学意义(P<0.01),坦索罗辛组较山莨菪碱组短,差异有统计学意义(P<0.01)。结论在输尿管下段结石体外冲击波碎石术后,坦索罗辛和山莨菪碱在辅助排石方面是安全、有效的,能缩短结石排石时间,坦索罗辛作用优于山莨菪碱。

Objective To compare the effectiveness of tamsulosin and anisodamine in the management of lower ureteral stones after ESWL. Methods A total of 90 patients with stones （0.4- 1.0 cm in diameter） located in the lower ureter were enrolled in the study and randomly divided into 3 groups （30 cases in each group）. Group 1 served as controls; group 2 received anisodamin （10 mg, 3 times daily） ; and group 3 received tamsulosin （0.4 mg once daily）. All patients were observed for 2 weeks. Results During 2 weeks, expulsion of stones was observed in 27 patients in group 1 （86.7%）, 28 in group 2 （93.3%） and 28 in group 3 （93.3%）, which was not statistically significant （P〉 0.05）. Average expulsion time for groups 1 to 3 was 5.6±4.0, 5.2±2.8 and 4.6±2.7 days, respectively, the difference of which in group 1 with respect to group 2 and 3 was significant （P〈0.01）; the difference of which in group 2 with respect to group 3 was significant （P〈0.01）. Conclusion It is demonstrated that tamsulosin and anisodamin are safe and effective in adjunctive expulsive treatments of lower ureteral stones after ESWL. They both can reduce the stone expulsion time, particularly tamsulosin.