联合应用α受体和M受体阻滞剂提高输尿管软镜手术中输尿管通道鞘置入成功率的效果

Effect ofα-blockers combined with M receptor blockers on improving the success rate of ureteral access sheath insertion in the treatment of flexible ureteroscopy surgery

目的观察联合应用α受体和M受体阻滞剂提高输尿管软镜手术中输尿管通道鞘(UAS)置入成功率的效果。方法将230例肾结石患者随机均分为五组:双J管1组和双J管2组分别于术前放置双J管1周和2周;药物1组和药物2组术前分别口服坦索罗辛+托特罗定和多沙唑嗪+托特罗定1周;对照组不做特殊处理。比较五组输尿管软镜手术中UAS置入成功率。结果 UAS置入成功率:双J管1组91.3%(42/46),双J管2组93.5%(43/46),药物1组87.0%(40/46),药物2组89.1%(41/46),对照组78.3%(36/46)。双J管1组、双J管2组、药物1组和药物2组UAS置入成功率均高于对照组(P<0.01)。结论输尿管软镜手术前联合应用α受体和M受体阻滞剂能达到术前放置双J管类似的效果。

Objective To observe the effect of α-blockers combined with M receptor blockers on improving the success rate of ureteral access sheath（UAS） insertion in the treatment of flexible ureteroscopy surgery. Methods A total of 230 patients with renal calculi was equally randomized into five groups. Groups of A1 and A2 were inserted with double-J stent one and two weeks before UAS insertion.Groups of D1 and D2 were treated with oral tamsulosin ＋ tolterodine and Doxazosin ＋ tolterodine one week before UAS insertion. Group C was not given any special treatment. The success rate of UAS insertion was compared among five groups. Results The success rates of UAS insertion were 91.3%（42/46） for group A1, 93.5% （43/46） for group A2, 87.0% （40/46） for group D1, 89.1%（41/46） for group D2, which were all higher than 78. 3% （36/46） in group C（P〈0. 01）. Conclusion Combined use of α-blockers and M receptor blockers can achieve a similar success rate of UAS insertion as double-J stent before flexible ureteroscopy surgery.