坦索罗辛在输尿管下段结石体外震波碎石术后辅助排石中的作用

Tamsulosin enhances lower ureteral stone clearance with extracorporeal shockwave 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体外震波碎石术(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后应用吲哚美辛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为试验组,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%,两组比较差异有显著统计学意义(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%,两组比较差异有显著统计学意义(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几率,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 evaluate the efficacy of α1-adrenergic antagonist in the management of lower ureteral stone with extraeorporeal shockwave lithotripsy（ESWL）. Methods A total of 64 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 Ⅱ cases （ 42. 3% ） of Group I ,in 30 cases （78. 9% ） 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 4 cases （ 15.4% ） 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.