输尿管镜联合坦索罗辛治疗老年输尿管结石的研究

Study of ureteroscopy combined with tamsulosin in the treatment of ureteral calculi in elderly patients

目的探讨输尿管镜钬激光碎石术(URSL)联合坦索罗辛提高手术成功率及辅助排石的临床疗效。方法将84例老年输尿管中下段结石病人随机分为对照组和联合治疗组,对照组病人仅接受URSL治疗,联合治疗组在URSL术前3 d开始加用坦索罗辛,比较2组病人手术成功率、术后各时间段的结石排净率、肾绞痛发生率及疼痛情况。结果联合治疗组病人手术成功率高于对照组,差异有统计学意义;对照组术后3 d及7 d的结石排净率与联合治疗组同期相比,差异无统计学意义(P>0.05);术后14 d及28 d的结石排净率均明显低于联合治疗组(P<0.05);联合治疗组肾绞痛的发生率及视觉模拟评分(VAS)均显著低于对照组(P<0.05)。结论URSL联合坦索罗辛既能够提高手术成功率,又能辅助排石,可缩短排石时间,安全可靠,值得临床推广应用。

Objective To observe and evaluate the clinical effect of tamsulosin combined with ureteroscopic pneumatic lithotripsy（URSL） in the treatment of ureteral calculi in elderly patients.Methods A total of 84 cases of ureteral calculi were randomly divided into two groups,the control group only receiving URSL,the treatment group receiving tamsulosin 3 days before URSL additionally. The surgery success rate,stone clearance rate after surgery,the occurrence rate of renal colic and pain were compared. Results The success rate in the treatment group was higher than that in the control group.After 3-day and 7-day treatment,the differences of stone clearance rate between the two groups were not significant（P〉0. 05）,while after 2-week and 4-week treatment,the stone clearance rate in the treatment group was much higher than that in the control group（P〈 0. 05）. The incidence rate of renal colic and VAS score of the treatment group were lower than those of the control group（P〈0. 05）. Conclusions Tamsulosin can not only improve the success rate of surgery and promote the excretion of gravel after URSL,but also increase quality of life and reduce expulsion time,which is worthy of clinical application.