坦索罗辛治疗输尿管各段结石疗效观察

Efficacy of Tamsulosin in the Management of Ureteral Stones

目的：评价坦索罗辛治疗输尿管结石的疗效。方法：296例输尿管结石患者随机分为两组,试验组151例患者服用坦索罗辛0.4 mg,1次/d＋尿石通4 g,2次/d;对照组145例患者服用尿石通丸4 g,2次/d,肾绞痛发作时根据需要每次使用盐酸哌替啶注射液50-100mg肌注。随访8周评估两组患者结石排出率、结石排出时间、镇痛药的使用率及药物副作用。结果：8周内试验组上、中、下段排石率分别为66.67%、71.43%、82.02%;对照组输尿管上、中、下段结石排除率分别为40.91%、25.00%、58.43%,两组比较差异均有统计学意义（P〈0.05）。试验组上、中、下段结石排出时间分别为（21.53±7.14）、（10.00±5.54）、（5.08±2.12）d,对照组上、中、下段结石排石时间分别为（29.86±6.36）、（15.00±4.08）、（7.75±2.45）d,两组比较差异有统计学意义（P〈0.05）。在两组中患者因肾绞痛发作不能耐受疼痛而需给予盐酸哌替啶注射液干预者,试验组上、中、下段结石患者分别为16.67%、14.29%、11.24%,对照组上、中、下段结石患者分别为54.55%、58.33%、39.33%,两组比较差异有统计学意义（P〈0.05）。试验组2例患者服用坦索罗辛后发生轻微头晕,因症状较轻未予对症处理,副作用发生率仅为1.32%。结论：坦索罗辛能显著提高输尿管结石的排出率,缩短结石排出时间,减少镇痛药物应用,且药物副作用少,在输尿管结石治疗中值得应用。

Objective： To evaluate the efficacy of Tamsulosin for the treatment of ureteral stones. Method： 296 patients with the ureteral stones（4-10 mm in diameter） were randomly divided into two groups.The experimental group accepted Niaoshitong pill（4 g,bid daily）and Tamsulosin（0.4 mg,once daily）,and the control group accepted Niaoshitong pill（4g,bid daily）. All patients were followed up for 8 weeks.The stone expulsion time,row stone rate, usage rate of analgesic, and side effects of medications were observed in both groups. Result：8 weeks, middle and lower segment row stone rate in experimental group were 66.67%, 71.43% and 82.02% respectively.In the control group were 40.91%, 25.00% and 58.43%, respectively, the differences had statistical significance（P0.05）.In the experimental group, middle and lower stone expulsion time respectively were（21.53±7.14）,（10.00±5.54）,（5.08±2.12） d, the control group respectively were（29.86±6.36）,（15.00±4.08）,（7.75±2.45）d, the differences had statistical significance（P0.05）. In the two groups of patients for renal colic attacks could＇t tolerate the pain and need to give the pethidine hydrochloride injection interveners, the experimental group middle and lower stone were 16.67%, 14.29%, 11.24%, the control group were 54.55%, 58.33%, 39.33%, the differences had statistical significance（P0.05）. In the experimental group,2 cases treated with Tamsulosin had slight dizziness, it did not suit the processing due to a lighter symptoms, the incidence of side effects only was 1.32%.Conclusion：It is demonstrated that Tamsulosin is safe and effective for the management of ureteral stones, it can significantly increased stone expulsion rate,shorten expulsion time, and reduce the need for analgesics.