甘露醇联合坦索罗辛治疗输尿管下段结石的临床研究

Clinical study of mannitol and tamsulosin therapy with lower ureteral calculus

目的探讨甘露醇联合坦索罗辛治疗输尿管下段结石的有效性和安全性。方法将168例确诊输尿管下段结石患者，随机分为4组（A、B组为C、D组的对照组）：结石≤5mm，未用甘露醇联合坦索罗辛治疗组（A组，对照组），使用甘露醇联合坦索罗辛组（C组，治疗组）；结石5～10mm，未用甘露醇联合坦索罗辛治疗组（B组，对照组），使用甘露醇联合坦索罗辛组（D组，治疗组）。随访1周，观察结石排出率、结石排出时间、疼痛发生率、药物不良反应和其它方法介入率情况。结果（1）结石≤5mm，治疗组的结石排出率为93．2％，显著高于对照组的73．2％（P〈0．05）。结石排出时间和疼痛发生率分别为（5．20±1．32）d和22．2％，均显著低于对照组的（9．10±1．82）d和58．3％（P均〈0．05）。（2）结石5—10mm，治疗组的结石排出率为38．3％，高于对照组的20．2％（P均〈0．05）。结石排出时间和疼痛发生率分别为（8．10±1．57）d和38．4％，均低于对照组的（11．20±1．72）d和65．7％（P均〈0．05）。（3）4组患者均未观察到明显的药物不良反应（P均〉0．05）。结论甘露醇联合坦索罗辛明显促进输尿管下段结石排出。有效缓解肾绞痛的发作．是治疗输尿管下段结石安全、有效的方法．佰得临床推广席用。

Objective To evaluate the efficacy and safety of mannitol association with tamsulosin in treatment of lower ureteral calculus. Methods A total of 168 patients with single lower ureteral calculus were enrolled in the study. All patients were randomized in four groups： The stone diameter was ≤5mm, Group A did not receive any medical treatment as blank control, group C received mannitol association with tamsulosin; The stone diameter was 5 - 10mm, Group B did not receive any medical treatment as blank control, group D received mannitol as- sociation with tamsulosin. Efficacy was evaluated in term of stone expulsion rate, expulsion time, pain episodes, and adverse drug reaction during a week of follow up. Results （ 1 ） The stone diameter was ≤ 5mm, experimental stone expulsion rate was 93.2%, significantly higher than the control group 73.2% （ P 〈0.05 ） ; expulsion time and pain episodes was （ 5.20 ± 1.32） d and 22.2%, were significantly lower than in the control group（9.10 ± 1.82）d and 58.3% （P 〈 0.05） ;（2）The stone diameter was 5 -10mm, experimental stone expulsion rate was 38. 3 %, higher than the control group 20.2% （ P 〈 0.05） ; expulsion time and pain episodes was （ 8.10 ± 1.57） d and 38.4%, also are lower than the control group（ 11.20 ± 1.72 ） d and 65.7% （ P 〈 0.05 ） ; （ 3 ） No serious adverse drug reaction was found in the four groups （ P 〉 0.05 ）. Conclusion The combined use of mannitol and tamsulosin increases stone expulsion and relieves renal colic episode, which should be recom- mended in the treatment for lower ureteral calculusl.