坦索罗辛在输尿管镜碎石术围手术期应用的前瞻性随机对照研究

Perioperative Application of Tamsulosin in Ureteroscopic Lithotripsy: A Prospective Randomized Controlled Study

目的探讨坦索罗辛在输尿管镜碎石术围手术期的应用价值。方法 2011年3月～2012年2月,60例拟行输尿管镜碎石术的输尿管结石者,采用随机数字表分为用药组(30例)与对照组(30例)。用药组术前1周开始服用坦索罗辛,0.2 mg,2次/d,持续至术后2周;对照组术前1周至术后2周未用任何α受体阻滞剂。比较2组输尿管镜进镜成功率、术中肾盂压力、术后2周结石排净率。结果用药组30例均未发生药物不良反应。2组输尿管镜进镜成功率差异无显著性[100%(30/30)vs.90%(27/30),P=0.237],用药组术中肾盂压力低[(14.71±1.32)cm H2O vs.(18.50±1.48)cmH2O,t=-10.468,P=0.000],术后2周结石排净率高[93%(28/30)vs.73%(22/30),χ2=4.320,P=0.038]。结论输尿管镜碎石术围手术期应用坦索罗辛可明显降低术中肾盂压力,提高术后结石排净率,但不能显著提高输尿管镜进镜成功率。

Objective To evaluate the efficacy of perioperative use of tamsulosin for ureteroscopic lithotripsy. Methods From March 2011 to February 2012, 60 patients, who were receiving ureteroscopic lithotripsy, were randomly divided into experimental and control groups. The experimental group took tamsulosin （0.2 mg, 2 times/d） since one week before the operation until two weeks after the operation; meanwhile the control groups didn＇ t receive any ct-adrenergic blocking agent. The success rate of inserting ureteroseope, intraoperative renal pelvic pressure and stone clearance rate in two weeks were compared between the two groups. Results No adverse reaction occurred in the experimental group. No significant difference was observed between the two groups in the success rate of inserting ureteroscope [ 100% （30/30） vs. 90% （27/30） , P =0. 237]. The experimental group, however, showed significantly lower intraoperative renal pelvic pressure and higher stone clearance rate [ （ 14.71 ± 1.32） cm H20 vs. （ 18.50 ± 1.48） em H20, t= -10.468, P=0. O00; 93% （28/30） vs. 73% （22/30）,X2 =4.320, P=0.038]. Conclusion Perioperativeuse of tamsulosin can increase stone clearance rate and decrease renal pelvic pressure, but cannot increase successful rate of ureteroscopie lithotripsy.