摘要
目的评估α1受体阻滞剂对7 mm以下的输尿管上段结石的辅助药物排石的临床疗效。方法将64例纳入研究的输尿管上段结石患者随机分成两组。A组患者接受黄体酮肌肉注射20 mg/d,双氯芬酸钠缓释胶囊100 mg/d,肾石通丸4.0 g/d治疗,B组在A组的基础上加用坦索罗辛0.4 mg/d治疗。每周随访一次,到结石排出为止共持续4周。比较两组患者在年龄、性别、结石大小、结石排出率、排出时间、肾绞痛的缓解率、需要住院观察的病例数之间的差异。结果两组患者在年龄、性别和结石直径上无统计学差异(P>0.05)。总排石率为50%(31/62),B组排石率显著高于A组[54.84%(17/31)vs.45.16%(14/31)],两组有统计学差异(P<0.05)。B组结石平均排出时间为(11±4.2)d,A组为(15±3.4)d,两者比较具有统计学差异(P<0.05)。B组肾绞痛缓解率为77.42%(24/31),A组为58.06%(18/31),两组在肾绞痛的缓解率上具有统计学差异(P<0.05)。两组在因出现尿路感染、肾绞痛加剧、肾积水加重等情况而住院进一步治疗的人数上也具有统计学差异(P<0.05),其中A组为8例,占25.81%(8/31),B组为3例,占9.68%(3/31)。结论α受体阻滞剂能有效辅助药物排石,提高输尿管上段结石患者的排石率,缩短排石时间,减轻肾绞痛症状及发作次数,降低住院率。
Objective To assess the clinic effect of αl-adrenoceptor antagonist facilitating the medical expulsive therapy for single upper ureteral calculi within 7 mm. Methods All eligible patients diagnosed as upper ureteral calculi were randomized into two group： goup A （n=32, progesterone intramuscular injection 20 rag per day, Diclofenac Sodium Sustained Release Capsules 100 mg per day, Shen Shi Tong 4.0 g per day） and group B （n=32, 0.4 mg tamsulosin once a day on the basis of group A）. Patients were evaluated every one week until stone expulsion or up to four weeks. The differences were compared in aging, gender, stone size, stone passage rate （SPR）, stone expulsion time, remission rate of renal colic, the number of patients needing to be hospitalized. Results There were no significant differences in aging, gender, stone size （/）〉0.05）. The cumulative SPR of the whole cohort was 50% （31/62）. The SPR of group B was significantly higher than group A [54.84% （17/31） vs. 45.16% （14/31）, P=-0.026〈0.05]. The stone expulsion time in group B was （11±4.2）d, while A was （15±3.4）d. There was significant difference between the two group. There also was significantly difference in the number of patients needing to be hospitalized as result of urinary tract infection, severe renal colic, enhanced hydronephrosis. The number of patients needing to be hospitalized in group B and A was 9.68% （3/31） and 25.81% （8/31） respectively. Conclusion α-adrenoceptor antagonists may facilitate medical expulsive therapy to enhance the SPR of upper ureteral calculi efficiently, minimize the stone expulsion time, alleviate the degree and frequency of renal colic, reduce hospitalization rates.
出处
《中华临床医师杂志（电子版）》
CAS
2015年第14期70-73,共4页
Chinese Journal of Clinicians(Electronic Edition)
