Purpose: We evaluated the efficacy of combined drug therapy with alpha1-adrenergic antagonist tamsulosin and corticosteroid deflazocort for conservative expulsive therapy in patients with lower ureteric calculi. Mater...Purpose: We evaluated the efficacy of combined drug therapy with alpha1-adrenergic antagonist tamsulosin and corticosteroid deflazocort for conservative expulsive therapy in patients with lower ureteric calculi. Materials and Methods: A total of 100 consecutive symptomatic patients with stones located in the Lower ureter were selected for the study who received oral tamsulosin 0.4 mg daily for 4 weeks and deflazocort 30 mg daily for 10 days and diclofenac IM/Oral on demand. Ultrasound follow-up and medical visits and X ray KUB were performed weekly for 4 weeks. Stone passage rate and time, pain episodes and endoscopical intervention were evaluated. Results: The stone expulsion rate was 87.8%. Mean stone size was 6.5 ± 2.14 mm. Mean expulsion time was 8 ± 1.84 days. Mean pain episodes were 1.50 ± 0.87 days. 11 patients needed intervention for stone retrieval. There was no statistically significant difference between the expulsion rates of right and left ureteral stones (P value = 0.31). Conclusions: Medical therapy with a combination of α<sub>1</sub> adrenergic blocker and corticosteroid achieve good stone expulsion rates, lower pain episodes and should be considered in all patients with lower ureteral stones of size less than 10 mm who are not having any contraindications for medical therapy.展开更多
Objective: To review the evidence for tamsulosin as medical expulsive therapy in enhancing the effectiveness of distal ureteral stone clearance rate. Methods: We searched Pubmed/Medline, Embase, CBM and the Cochrane L...Objective: To review the evidence for tamsulosin as medical expulsive therapy in enhancing the effectiveness of distal ureteral stone clearance rate. Methods: We searched Pubmed/Medline, Embase, CBM and the Cochrane Library up to October 2011. All randomized controlled trials in which tamsulosin was evaluated with distal ureterolithiasis were eligible for the analysis. Outcome measure assessed was stone clearance rate. Two authors independently assessed study quality and extracted data. All data were analyzed using RevMan 5.1. Results: Thirteen studies involving 1067 participants met the inclusion criteria. Study duration ranged from 7 to 42 d. The pooled analysis showed an improvement of 41% in stone clearance rate of tamsulosin as medical expulsive therapy for distal ureteral calculi (RR=1.41, 95% CI=1.18 to 1.70). According to stone size (6 mm<size<10 mm, 5 mm<size<6 mm, size <5 mm), the pooling effects of tamsulosin were analyzed, with a higher stone expulsion rate obtained than control (RR=1.52, 1.75, 1.05, 95% CI=1.30 to 1.77, 1.25 to 2.45, 0.95 to 1.16, respectively). Adverse effects of tamsulosin, mainly retrograde ejaculation, dizziness and hypotension, were reported in 7 included trials. Conclusion: Treatment with tamsulosin appears to be a safe and effective medical expulsion therapy for distal ureterolithiasis. To make a definite clinical recommendation to use tamsulosin as medical expulsive treatment for distal ureteral calculi, high quality multicentric, randomized, double blinded, controlled trials are necessary to prove its efficacy.展开更多
目的分析输尿管结石碎石术后运用盐酸坦索罗辛缓释胶囊、双石通淋胶囊联合辅助排石的效果及对炎症因子的影响。方法120例输尿管结石碎石术后患者,通过随机数字表法分为对照组和观察组,每组60例。对照组采取盐酸坦索罗辛缓释胶囊治疗,观...目的分析输尿管结石碎石术后运用盐酸坦索罗辛缓释胶囊、双石通淋胶囊联合辅助排石的效果及对炎症因子的影响。方法120例输尿管结石碎石术后患者,通过随机数字表法分为对照组和观察组,每组60例。对照组采取盐酸坦索罗辛缓释胶囊治疗,观察组采用盐酸坦索罗辛缓释胶囊+双石通淋胶囊治疗。比较两组临床疗效、用药不良反应发生率及治疗前后炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、疼痛感变化情况。结果与对照组相比,观察组治疗总有效率(95.00%VS 81.67%)更高(P<0.05)。治疗后,对照组和观察组CRP、IL-6、TNF-α均低于治疗前,且与对照组相比,观察组CRP(2.84±0.81 VS 5.36±1.21)mg/L、IL-6(97.79±0.33 VS 122.16±13.57)pg/ml、TNF-α(4.31±1.19 VS 6.44±1.31)μg/L均更低(P<0.05)。治疗后,对照组和观察组视觉模拟评分法(VAS)评分均低于治疗前,且与对照组相比,观察组VAS评分(1.86±0.24 VS 3.58±0.89)分更低(P<0.05)。与对照组相比,观察组用药不良反应发生率(6.67%VS 21.67%)更低(P<0.05)。结论对输尿管结石碎石术后患者采取盐酸坦索罗辛缓释胶囊、双石通淋胶囊联合治疗,可起到辅助排石作用,降低炎症相关因子表达水平,减轻术后疼痛感,且用药不良反应发生率较低,临床安全性、有效性较高,值得推荐。展开更多
文摘Purpose: We evaluated the efficacy of combined drug therapy with alpha1-adrenergic antagonist tamsulosin and corticosteroid deflazocort for conservative expulsive therapy in patients with lower ureteric calculi. Materials and Methods: A total of 100 consecutive symptomatic patients with stones located in the Lower ureter were selected for the study who received oral tamsulosin 0.4 mg daily for 4 weeks and deflazocort 30 mg daily for 10 days and diclofenac IM/Oral on demand. Ultrasound follow-up and medical visits and X ray KUB were performed weekly for 4 weeks. Stone passage rate and time, pain episodes and endoscopical intervention were evaluated. Results: The stone expulsion rate was 87.8%. Mean stone size was 6.5 ± 2.14 mm. Mean expulsion time was 8 ± 1.84 days. Mean pain episodes were 1.50 ± 0.87 days. 11 patients needed intervention for stone retrieval. There was no statistically significant difference between the expulsion rates of right and left ureteral stones (P value = 0.31). Conclusions: Medical therapy with a combination of α<sub>1</sub> adrenergic blocker and corticosteroid achieve good stone expulsion rates, lower pain episodes and should be considered in all patients with lower ureteral stones of size less than 10 mm who are not having any contraindications for medical therapy.
文摘Objective: To review the evidence for tamsulosin as medical expulsive therapy in enhancing the effectiveness of distal ureteral stone clearance rate. Methods: We searched Pubmed/Medline, Embase, CBM and the Cochrane Library up to October 2011. All randomized controlled trials in which tamsulosin was evaluated with distal ureterolithiasis were eligible for the analysis. Outcome measure assessed was stone clearance rate. Two authors independently assessed study quality and extracted data. All data were analyzed using RevMan 5.1. Results: Thirteen studies involving 1067 participants met the inclusion criteria. Study duration ranged from 7 to 42 d. The pooled analysis showed an improvement of 41% in stone clearance rate of tamsulosin as medical expulsive therapy for distal ureteral calculi (RR=1.41, 95% CI=1.18 to 1.70). According to stone size (6 mm<size<10 mm, 5 mm<size<6 mm, size <5 mm), the pooling effects of tamsulosin were analyzed, with a higher stone expulsion rate obtained than control (RR=1.52, 1.75, 1.05, 95% CI=1.30 to 1.77, 1.25 to 2.45, 0.95 to 1.16, respectively). Adverse effects of tamsulosin, mainly retrograde ejaculation, dizziness and hypotension, were reported in 7 included trials. Conclusion: Treatment with tamsulosin appears to be a safe and effective medical expulsion therapy for distal ureterolithiasis. To make a definite clinical recommendation to use tamsulosin as medical expulsive treatment for distal ureteral calculi, high quality multicentric, randomized, double blinded, controlled trials are necessary to prove its efficacy.
文摘目的分析输尿管结石碎石术后运用盐酸坦索罗辛缓释胶囊、双石通淋胶囊联合辅助排石的效果及对炎症因子的影响。方法120例输尿管结石碎石术后患者,通过随机数字表法分为对照组和观察组,每组60例。对照组采取盐酸坦索罗辛缓释胶囊治疗,观察组采用盐酸坦索罗辛缓释胶囊+双石通淋胶囊治疗。比较两组临床疗效、用药不良反应发生率及治疗前后炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、疼痛感变化情况。结果与对照组相比,观察组治疗总有效率(95.00%VS 81.67%)更高(P<0.05)。治疗后,对照组和观察组CRP、IL-6、TNF-α均低于治疗前,且与对照组相比,观察组CRP(2.84±0.81 VS 5.36±1.21)mg/L、IL-6(97.79±0.33 VS 122.16±13.57)pg/ml、TNF-α(4.31±1.19 VS 6.44±1.31)μg/L均更低(P<0.05)。治疗后,对照组和观察组视觉模拟评分法(VAS)评分均低于治疗前,且与对照组相比,观察组VAS评分(1.86±0.24 VS 3.58±0.89)分更低(P<0.05)。与对照组相比,观察组用药不良反应发生率(6.67%VS 21.67%)更低(P<0.05)。结论对输尿管结石碎石术后患者采取盐酸坦索罗辛缓释胶囊、双石通淋胶囊联合治疗,可起到辅助排石作用,降低炎症相关因子表达水平,减轻术后疼痛感,且用药不良反应发生率较低,临床安全性、有效性较高,值得推荐。
