托特罗定联合坦索罗辛治疗输尿管结石临床价值

Clinical value of tolterodine combined with tamsulosin on the treatment of ureteral calculi

目的探讨托特罗定联合坦索罗辛治疗输尿管结石的临床效果和安全性。方法将解放军11医院自2012年2月至2014年5月收治的219例输尿管结石患者,按随机数字表法分为两组。其中,观察组110例患者,使用托特罗定联合坦索罗辛进行治疗;对照组109例患者,仅使用坦索罗辛治疗。治疗4周后,比较两组患者的结石排石率、结石排出时间、肾绞痛发生率及疼痛视觉模拟评分(VAS)等指标并记录不良反应发生情况。结果观察组患者的总结石排石率为76.4%(84/110),对照组的结石排除率为57.8%(63/109),两组比较,差异有显著统计学意义(P<0.01)。观察组平均结石排出时间和VAS评分均低于对照组,差异有显著统计学意义(P<0.01)。观察组输尿管下段结石组肾绞痛发生率为13.2%(9/68),对照组为27.9%(17/61),两组比较,差异有统计学意义(P<0.05)。观察组的不良反应发生率为8.2%(9/110),对照组为5.5%(6/109),两组比较,差异无统计学意义(P>0.05),两组均无严重不良反应发生。结论托特罗定联合坦索罗辛治疗输尿管结石安全有效,尤其可提高输尿管中下段结石的清除率,缩短结石排出时间,减轻疼痛。

Objective To investigate tolterodine combined with tamsulosin clinical effect and safety in the treatment of ureteral calculi. Methods Totally 219 cases with ureteral calculi from February 2012 to May 2014 in our hospital were randomly divided into the observation group and the control group. In observation group,110 cases who had undergone tolterodine combined with tamsulosin. In control group,109 cases who had undergone tamsulosin only. All the cases were treated and accepted follow-ups for 4 weeks. Patients of both groups were compared in success rate of stone clearance,time of calculi expulsion,incidence of renal colic episodes and visual analogue scale pain score. Adverse effects were recorded. Results The rate of stone clearance were 76. 4%（84 /110） for the observation group and 57. 8%（63 /109） for the control group（ P〈 0. 01）. The time for calculi expulsion and visual analogue scale pain score had significantly decreased in patients of observation group compared with the ones of control group. The rate of renal colic episodes of lower ureteral calculi were 13. 2%（9 /68） for the observation group and 27. 9%（17 /61） for the control group（ P〈 0. 05）. The total incidences of adverse events in observation group and control group were 8. 2%（9 /110） and 5. 5%（6 /109）,respectively. And there was no severe adverse event happened in both groups. Conclusion Tolterodine combined with tamsulosin is safe and efficient in the treatment of ureteral calculi. Tolterodine combined with tamsulosin may improve the stone clearance,shorten the mean time for calculi expulsion,decrease the visual analogue scale pain score in patients with middle and lower ureteral calculi.