52例α1受体阻滞剂在输尿管上段结石体外冲击波碎石术后的应用

The use of alpha1 blocker for upper ureteral calculi after extracorporeal shock wave lithotripsy

目的探讨α1受体阻滞剂对输尿管上段结石体外冲击波碎石术(ESWL)术后辅助排石的初步经验。方法分析2006年1月至2010年5月108例输尿管上段结石ESWL患者的临床资料,患者随机分成两组:A组52例,B组56例。所有患者ESWL术后予司帕沙星0.2g,每天1次,A组接受上述治疗的同时,另加用坦索罗辛0.4mg,每日1次,所有患者日均饮水2L以上,进行日常活动。结果 A组与B组结石平均排出时间分别为4.10、6.91d,肾绞痛发生率为8%和29%,差异有统计学意义(P<0.05);结石排出率分别为82.7%、58.9%,一次ESWL后结石排净率分别为75.0%、44.6%,差异无统计学意义(P>0.05)。结论坦索罗辛可明显缩短输尿管上段结石患者的排石时间,减少肾绞痛发生次数,使用安全、痛苦少、恢复快。

Objective To evaluate the efficacy and the safety of alpha1-blocker for the patients with upper urinary tract calculi after extracorporeal shock wave lithotripsy（ESWL）.Methods From January 2006 to May 2010,108 patients with upper urinary tract calculi randomly divided into two groups,group A,52 patients and group B,56 patients.All of the patients underwent ESWL and antibiotic（Sparfloxacin 200mg QD）,the patients of group A received Tamsulosin 0.4 mg daily.All patients were advised to drink water more than 2L every day and keep the normal amount of exercise daily.Results The mean stone expulsion time was 4.10d and 6.91d,The mean renal colic person times of the total experimental group and control group was 0.08 and 0.29 respectively,with a statistic significant difference between the two groups（P〈0.05）.The stone expulsion rate of group A and group B was 82.7% and 58.9% respectively,The stone free rate was 75.0%and 44.6% after one ESWL session,without statistics significant difference between the two groups（P〈0.05）.Conclusion For the patients with upper urinary tract calculi after ESWL,Alpha1 blocker can shorten stone expulsion time,reduce frequency of renal colic.Morever,it is a safe and less traumatic method for the patients.