坦索罗辛对输尿管下端结石ESWL术后排石的疗效观察

Effects of tamsulosin on clearance of lower ureteral stones after extracorporeal shock wave lithotripsy

目的:探讨坦索罗辛对输尿管下端结石急诊体外冲击波碎石(ESWL)术后排石的疗效。方法:120例输尿管下端结石患者接受单次ESWL术后,随机分为2组:A组为肾石通颗粒+山莨菪碱组,B组为肾石通颗粒+山莨菪碱+坦索罗辛组。随访观察4周。结果:B组60例中,排出结石58例,排石率为96.7%;A组60例中排出结石48例,排石率80.0%。B组60例中,排净结石55例,排净率为91.7%;A组60例中排净结石41例,排净率为68.3%。B组结石排出时间为(5.13±3.07)d,A组为(7.37±3.63)d。止痛剂使用率比较,B组为35.0%,A组58.3%。B组结石排出率、结石排净率、结石排出时间、止痛剂使用率与A组相比均有统计学差异(P均<0.05)。结论:坦索罗辛可提高输尿管下端结石患者ESWL术后的结石排出率、结石排净率,缩短患者的排石时间,减少止痛剂的使用率,药物不良反应发生少,疗效显著并且使用安全。

Objective： To observe the clinical effect of tamsulosin on clearance of the lower utreteral calculi in patients after extracorporeal shock wave lithotripsy（ ESWL）. Methods： A total of 120 patients with lower ureteral stones undergone single ESWL were equally randomized into two groups. Group A were treated with anisodamine plus shenshitong granule,and group B by shenshitong granule ＋ anisodamine ＋ tamsulosin. The patients of the two groups were followed up for 4 weeks to examine the therapeutic efficacies. Results： The stones were removed in 58 of 60 patients in group B（ 96. 7%） with clearance rate of 91. 7%（ 60 /55）,and 48 of 60 in group A（ 80. 0%） with clearance rate of 68. 3%（ 60 /41）. The time to clear the stones were（ 5. 13 ± 3. 07）days for group B and（ 7. 37 ± 3. 63） days for group A. 35. 0% of patients in group B required analgesic use compared to 58. 3% in group A. The two groups were statistically significant concerning the clearance rate,success rate,removal time and analgesic use（ all P〈0. 05）. Conclusion： Tamsulosin may be safe and effective for patients with lower ureteral calculi after ESWL,for it can improve the successful removal of the stones and clearance rate as well as reduce the stone expulsion time,analgesic use and adverse effects.