坦索罗辛联合局部麻醉输尿管下段内镜碎石术治疗老年输尿管下段结石的效果分析

Comparison of the therapeutic effect of tamsulosin combined with local anesthesia in endoscopic lithotripsy for the treatment of elderly patients with lower ureteral calculi

目的比较坦索罗辛联合局部麻醉与单纯局部麻醉输尿管下段内镜碎石术治疗老年输尿管下段结石的效果,探讨联合方案的临床应用价值。方法选取本院2014年2月至2016年2月收治的224例老年输尿管下段结石患者为研究对象,按照随机数表法将其分为观察组和对照组,每组各112例。所有患者均行局部麻醉下内镜碎石术治疗,观察组患者术后口服坦索罗辛,持续1周。比较两组患者治疗情况、术后并发症发生情况及术后6个月结石复发情况,并比较两种治疗方案的疗效与安全性。结果观察组患者手术时间和住院天数均短于对照组(P<0.05),住院费用低于对照组(P<0.05),两组患者结石清除率均为100.00%。两组患者并发症均以轻度尿频/尿急、血尿、肋腹区疼痛为主,并发症发生率及分级比较差异均无显著性(P>0.05)。观察组和对照组患者术后6个月结石复发率分别为11.61%和13.39%,组间比较差异无显著性(P>0.05)。结论坦索罗辛联合局部麻醉输尿管下段内镜碎石术能够在保证碎石效果与安全性的基础上,规避术后留置管路所致创伤增加、恢复慢、治疗费用高等问题,为老年患者术后无管化治疗提供了可能。

Objective To compare the therapeutic effect of tamsulosin combined with local anesthesia in endoscopic lithotripsy for the treatment of elderly patients with lower ureteral calculi, and to explore the clinical value of the combined scheme. Method 224 elderly patients with ureteral calculi treated in our hospital from February 2014 to February 2016 were selected as the study objects. They were divided into observation group and control group according to the method of random number table. All patients were underwent endoscopic lithotripsy. Patients in observation group were treated with tamsulosin orally for 1 week. The incidence of postoperative complications and recurrence of stones at 6 months after operation, as well as the curative effect and safety of the two treatment regimens were compared between the two groups. Result The operation time and hospital day of observation group were shorter than control group（P〈0.05）, and hospitalization cost was lower than control group（P〈0.05）. Two groups of patients with stone clearance rate was 100.00%. Two groups of patients with complications were mainly mild urinary frequency/urgency, hematuria, flank pain, there were no significant differences between the incidence of complications and grading（P〉0.05）. 6 months after operation, the recurrence rate of observation group and control group was 11.61% and 13.39%, respectively, and there was no significant difference between the two groups（P〉0.05）. Conclusion Tamsulosin combined with local anesthesia in the lower ureteral endoscopic lithotripsy can guarantee the effect and safety of gravel on the basis of avoiding postoperative tracheal-caused increasing indwelling, slow recovery, high cost of treatment, and provides the possibility for the elderly patients with non-tubular treatment.