盐酸坦洛新在输尿管下段结石体外冲击波碎石术后辅助排石的效果观察

Tamsulosin Hydrochloride for Stone Removal after Extracorporeal Shock Wave Lithotripsy in Treatment of Lower Ureteral Calculi

目的探讨输尿管下段结石行体外冲击波碎石术(ESWL)术后应用盐酸坦洛新辅助排石的临床效果。方法选取2015年1月至2016年3月收治的134例输尿管下段结石且行ESWL患者,按随机数字表法分为2组,每组67例。对照组:术后给予常规治疗;观察组:在对照组基础上,联合应用盐酸坦洛新治疗。记录比较2组ESWL术后3、7、14及28d结石排净率,结石排净时间及药物治疗结束后随访4周期间视觉模拟评分法(VAS)评分、镇痛药使用率,药物治疗期间不良反应。结果 2组ESWL术后3、7d时的结石排净率比较,差异无统计学意义(P>0.05);观察组ESWL术后14、28d的结石排净率均显著高于对照组同期(P<0.01),观察组结石排净时间及随访期间VAS评分、镇痛药使用率均明显优于对照组(P<0.05);2组不良反应比较,差异无统计学意义(P>0.05)。结论输尿管下段结石行ESWL术后应用盐酸坦洛新辅助治疗效果切实,安全性高,具有较高临床参考价值。

Objective To investigate the clinical efficacy of tamsulosin hydrochloride for stone removal after extracorporeal shock wave lithotripsy（ESWL）in the treatment of lower ureteral calculi.Methods A total of patients with lower ureteral calculi were randomly given conventional treatment alone（control group,n=67）or in combination with tamsulosin hydrochloride（observation group,n=67）after ESWL between January 2015 and March 2016.The stone-free rates and stone removal time were recorded 3,7,14 and 28days after ESWT.Furthermore,VAS scores and analgesic usage rates were recorded during 4weeks of follow-up and adverse drug reactions were observed during treatment.Results There were no significant differences between the two groups in stone-free rates 3and 7days after ESWT,as well as in adverse drug reactions during treatment（P〉0.05）.Compared with control group,tamsulosin hydrochloride treatment increased the stone-free rates 14 and 28days after ESWT and improved the stone removal time,VAS scores and analgesic usage rates（P〈0.01 or P〈0.05）.Conclusion The application of tamsulosin hydrochloride as an adjuvant therapy after ESWL is effective,safe and valuable for lower ureteral calculi.