坦索罗辛联合索利那新在输尿管下段结石体外冲击波碎石术后辅助排石中的应用

Tamsulosin combined with solifenacin for treatment of distal ureteral calculi after extracorporeal shock-wave lithotripsy

目的：探讨坦索罗辛联合索利那新在输尿管下段结石体外冲击波碎石术（ESWL）后辅助排石中的应用效果.方法：将270例输尿管下段结石患者随机分为A、B和C3组,每组90例.所有患者给予EWSL治疗后,A组口服坦索罗辛0.2 mg,B组口服索利那新5 mg,C组口服索利那新5 mg、坦索罗辛0.2 mg,均为每天1次.比较各组结石清除率、排石时间、肾绞痛再发率、石街形成率及服药期间的药物不良反应.结果：对于6～10 mm的小结石,3组患者结石清除率差异无统计学意义（P＞0.05）.对于＞10 mm的大结石,C组的清除率为100.0％,A组90.5％,B组84.8％,差异有统计学意义（P＜0.05）;C组结石排出时间均明显少于A组和B组（P＜0.01）,而C组排石期间的疼痛程度低于B组（P＜0.05）,3组肾绞痛再发率和石街形成率差异均无统计学意义（P＞0.05）;3组均未见明显不良反应.结论：输尿管下段结石ESWL术后联合应用坦索罗辛、索利那新安全有效,可缩短排石时间,降低石街形成率,尤其适用于直径＞10 mm的大结石.

Objective：To explore the effect of tamsulosin combined with solifenacin for the treatment of distal ureteral calculi after extraeorporeal shock-wave lithotripsy （ESWL）. Methods： Two hundred and seventy patients with distal ureteral calculi were evenly divided into three groups. After ESWL, group A were administered tamsulosin 0.2 rag, group B solifenacin 5 mg and group C solifenacin 5 mg plus tamsulosin 0.2 mg once a day. The expulsion rate and expulsion time of the stone, the recurrence of renal colic, the steinstrasse formation and the side effects during the therapy were compared among the three groups. Resldts：For the lithiasis 6 - 10 mm in diameter, there was no significant difference in the stone expulsion rate （P 〉 0.05 ） ;for the lithiasis 〉 10 mm in diameter, the stone expulsion rate of group C（ 100.0% ） was significantly higher than that of group A（90.5% ） and group B（84.8% ） （P 〈 0.05 ） ; the expulsion time of the stone in group C was shorter than group A and B （P 〈 0.01 ）, but the pain degree during the stone expulsion in group C was lower than group B （ P 〈 0.05 ）. The recurrence rate of renal colic and the steinstrasse formation rate had no significant differences among the three groups（ P 〉 0.05 ）. No severe side effects were observed among the three groups（ P 〉 0.05 ）. Conclusions ： Combination use of tamsulosin and solifenacin is safe and effective for treatment of distal ureteral calculi after extracorporeal shock-wave lithotripsy. It may shorten the stone expulsion time and reduce the steinstrasse formation rate, and is especially suitable for the lithiasis 〉 10 mm in diameter.