氢氯噻嗪联合盐酸坦索罗辛治疗146例输尿管结石体会

The experience about the treatment of 146 cases with ureteral calculus with hydrochlorothiazide combining with tamsulosin hydrochloride

目的研究氢氯噻嗪联合盐酸坦索罗辛治疗输尿管结石临床效果及不良反应。方法研究对象共146例,随治疗方法不同分为观察组(n=80)与对照组(n=66)。对照组采用单纯盐酸坦索罗辛治疗,观察组加入氢氯噻嗪。观察两组用药后结石排出时间、疼痛程度、合用止痛药情况、不良反应情况及24～48 h肾绞痛再发率。结果两组结石大小对比,差异无统计学意义(P>0.05);观察组结石排出时间为(5.78±3.23)d,明显优于对照组,差异有统计学意义(P<0.05);观察组疼痛程度为(1.50±0.31)分,与对照组对比,差异有统计学意义(P<0.05)。观察组用药后再次发生肾绞痛22例,其中18例使用止痛药,4例疼痛可以忍受,自行缓解;2例发生不良反应,1例为短暂性低血压,1例为氢氯噻嗪过敏。对照组肾绞痛再发率、止痛药使用率均明显高于观察组,差异有统计学意义(P<0.05);1例并发症患者为眩晕、无力。结论体外冲击波碎石后予氢氯噻嗪联合盐酸坦索罗辛口服,可有效缩短排石时间,降低肾绞痛再发率、减轻疼痛强度,且不增加不良反应,值得临床推广。

Objective To explore the clinical effect and untoward effect about the treatment ot ureteral calculus with hydrochtorothiazide combining with tamsulosin hydrochloride. Methods Selected 146 patients as the research subject. According to different therapy methods were randomly divided into contrast group with 66 cases and observation group with 80 cases. Patients in contrast group simply adopted the treatment of tamsulosin hydrochloride while patients in observation group adopted the treatment of tamsulosin hydrochloride which were added with hydrochlorothiazide. Then analyzed the time of lithecbole, the severity of pain, the condition of combined analgesics, the condition of untoward effect as well as the recurrence rate of 24-48 h renal colic after treatment between two groups. Results Compared the size of lithiasis in two groups, there was no statistical difference （P 〉 0.05）. The time of lithecbole in observation group was （5.78±3.23）d, which was better than the contrast group obviously. The difference had a statistical significance （P 〈 0.05）. Compared with the contrast group, the severity of pain was （1.50±0.31）. The difference was significant （P 〈 0.05）. About 22 cases in observation group occurred renal colic again after the treatment. In all 22 cases, 18 cases adopted acesodyne, 4 cases suffered the pain and had a spontaneous remission, 2 cases appeared untoward effect, 1 case was transient hypotension, 1 case was allergic to hydrochlorothiazide. The occurance of renal colic again, the unilization ratio of acesodyne, the incidence rate of untoward effect in the contrast group were obviously higher than that in obser vation group. The result exists significant difference （P 〈 0.05）. 1 case with ureteral calculus was delirium and feel weak. Conclusion After extracorporeal shock with calculus, oral contraception use of hydroehlorothiazide combining with tamsulosin hydrochloride can effectively shorten the time of lithecbole, reduce the oecurance of renal colic again, alleviate the severity of pain and not intensify adverse reaction. It is valuable applied in the clinic.