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应用

Application of tamsulosin in lower ureteral stone extracorporeal shock wave lithotripsy

目的探讨输尿管下段结石应用体外冲击波碎石术(ESWL)后坦索罗辛辅助排石的临床疗效。方法对我院2009年4月至2012年1月收治的79例输尿管下段结石患者采用ESWL术后,按服药的不同随机分成2组,即对照组39例和实验组40例。对照组应用肾石通冲剂口服治疗,实验组在对照组治疗的基础上应用坦索罗辛0.4 mg口服,1次/d。观察两组患者治疗后结石排出情况和再次发生肾绞痛的情况。结果实验组和对照组结石排出率分别为87.50%和69.23%,结石排出时间分别为(5.3±1.0)、(9.8±1.1)d,再次发生肾绞痛而需要镇痛药治疗的患者分别为7.5%和15.38%(P<0.05)。两组患者治疗前后收缩压和舒张压变化比较差异均无统计学意义(P>0.05)。结论输尿管下段结石体外震波碎石术后辅助应用坦索罗辛能增加排石率,缩短结石排出时间,减少再次发生肾绞痛的几率,且安全有效,值得临床推广应用。

Objective To explore the clinical efficacy of tamsulosin on the lower ureteral stone extracorporeal shock wave lithotripsy（ESWL）.Methods From April 2009 to January 2012,79 cases of lower ureteral stones patients with ESWL after surgery were randomly divided into two groups according to different medications.The control group（n=39） was given kidney stone granules oral therapy;experimental group（n=40） was given tamsulosin 0.4 mg orally,once daily on the basis of control group′s therapy.Stone expulsion and recurrence of renal colic of the two groups were observed after treatment.Results The stone expulsion rate in the experimental group and control group were 87.50% and 69.23% respectively（P0.05）;stone expulsion time were（5.3±1.0）d and（9.8±1.1）d respectively（P0.05）;the recurrence rates of renal colic requiring analgesic therapy were 7.5% and 15.38% respectively（P0.05）.The systolic and diastolic blood pressure of the two groups showed no significant difference after treatment（P0.05）.Conclusion The application of tamsulosin on lower ureteral calculi in vitro after shock wave lithotripsy auxiliary can increase the lithotripsy rate,shorten the stone expulsion time,reduce the risk of the recurrence of renal colic,it is worthy of clinical application.