α受体阻滞剂在经皮肾镜碎石术围手术期的应用观察

Clinical investigation on using alpha-adrenergic receptor antagonists during perioperative period of percutaneous nephrolithotomy

①目的探讨α受体阻滞剂降低经皮肾镜手术患者并发症的发生率。②方法采用临床随机对照研究的方法,选择因肾结石行经皮肾镜碎石术治疗的患者100例。按照随机数字表法将研究对象随机分为A、B两组。A组术前及术后给予α受体阻滞剂药物治疗;B组给予安慰制剂胶囊治疗。B超辅助诊断各组患者术后肾周积液情况,比较早期发热、肾区胀痛及肾功能减退等并发症的发生率,分析比较两组患者尿常规结果。③结果 A组肾周渗出积液量平均值(2.3±0.3)cm,B组肾周渗出积液量平均值(4.8±0.2)cm,两组有统计学差异(P<0.05)。A、B组患者术后6、24、48小时及第5天的发热发生率、肾区胀痛发生率、短暂的肾功能减退发生率差异均有统计学意义(P<0.05)。A组与B组尿常规红细胞检出率100%,无统计学差异。A、B组患者术后6、24、48小时及第5天尿管型检出率,差异有显著统计学意义(P<0.05)。④结论围手术期使用α受体阻滞剂,对经皮肾镜手术并发症发生率的降低效果显著,对促进患者早日康复有重要意义。

Objective To evaluate the efficacy of alpha - adrenergic receptor antagonists used to reduce complications of pereutaneous nephrolithotomy. Methods A prospective randomized controlled clinical trial was carried out. A total of 100 patients with renal stone disease underwent percutaneous nephrolithotomy were randomly divided into 2 groups, which were chosen from the patients were hospitalized. In group A, patients took alpha - adrenergic receptor antagonists during perioperative period of percutane- ous nephrolithotomy . In group B, patients took drug of placebo. Color doppler ultrasound was used in diagnosis of patients after per- cutaneous nephrolithotomy with perirenal effusion. All the patients were followed up in order to record the rates of fever , renal pain and impaired renal function and through analysis and comparison of urine routines of the two groups. Results The comparison be- tween two groups revealed no significant differences in the percent of males, age, and renal calculus , but there was significant differ- ence in perirenal effusion, fever , renal pain and impaired renal function. There were no significant differences in the percent of rbc of urine routines,but significant difference in tube - type of urine routines. Conclusion Using alpha - adrenergic receptor antago- nists during perioperative period is an effective procedure to reduce complications of pereutaneous nephrolithotomy and protect renal function,which promotes an early recovery of patients.