摘要
目的研究盐酸坦索罗辛联合速尿注射液在体外冲击波碎石(ESWL)后治疗输尿管不同部位结石中的临床效果及不良反应。方法入组研究对象共238例,随机分为观察组(共120例,其中输尿管中上段结石55例,输尿管下段结石65例)与对照组(共118例,其中输尿管中上段结石58例,输尿管下段结石60例)。对照组采用单纯速尿及抗炎解痉止痛治疗,观察组在对照组基础上加用盐酸坦索罗辛,观察两组用药后不同部位输尿管结石的排出时间、清石率、绞痛再发率及疼痛程度、应用止痛药情况以及药物不良反应情况。结果两组患者结石体积在输尿管不同部位比较差异无统计学意义(P>0.05)。观察组结石排出时间中上段为(5.36±2.12)d、下段(4.34±2.42)d,均明显短于对相应部位对照组[(8.76±1.51)d和(7.20±1.03)d];观察组结石清石率中上段89.09%、下段92.31%,均高于相应部位对照组(74.14%及80.00%)。观察组再次发生肾绞痛25例(中上段19例,下段6例),其中13例使用止痛药;对照组肾绞痛再发54例(中上段40例,下段14例),止痛药使用30例。观察组ESWL后疼痛程度中上段结石(1.73±0.41)分、下段结石(1.45±0.31)分,对照组中上段结石(2.17±0.43)分、下段结石(1.92±0.22)分,以上结石的排出时间、清石率、绞痛再发率及疼痛程度、应用止痛药情况两组对比的差异均有统计学意义(P<0.05)。观察组4例(中上段及下段各2例)发生药物不良反应均为体位性低血压;对照组3例(中上段2例,下段1例)发生药物不良反应均为头痛;差异各组比较无统计学意义(P>0.05)。结论体外冲击波碎石后口服盐酸坦索罗辛联合应用速尿可有效缩短排石时间,提高清石率,降低肾绞痛再发率,减轻疼痛强度,且不增加不良反应,临床应用安全有效。
Objective To explore the efficacy and side‐effect of tamsulosin hydrochloride with furosemide in the treat‐ment of calculi in different parts of ureter after extracorporeal shock wave lithotripsy （ESWL） .Methods Clinical data of 238 patients with ureteral stones treated during June 2010 and June 2014 were retrospectively analyzed .The patients were ran‐domly divided into observation group （n=120 ,55 with stones in middle or upper parts of ureter ,65 with stones in lower part of ureter） and control group （n=118 cases ,58 with stones in middle or upper parts of ureter ,60 with stones in lower part of ureter） .Patients in control group received treatment of furosemide ,while patients in observation group received treatment of tamsulosin hydrochloride with furosemide .The time of lithecbole ,stone clearance rate ,incidence and severity of pain ,condi‐tion of combined analgesics as well as side‐effect were compared between the two groups .Results There was no statistical difference between the size of lithiasis （P〉0 .05） .The time of lithecbole in observation group was （5 .36 ± 2 .12）d in middle or upper parts of ureter and （4 .34 ± 2 .42）d in lower part of ureter ,which was shorter than that of the control group [（8 .76 ± 1.51）d and （7 .20 ± 1 .03）d ,respectively] .The difference had a statistical significance （ P〈0 .05） .The stone clearance rate of observation group was 89 .09% in middle or upper parts of ureter and 92 .31% in lower part of ureter ,which was significantly higher than that of the control group （74 .14% and 80 .00% ,respectively ,P〈0 .05） .25 cases （19 cases in middle or upper parts of ureter and 6 cases in lower part of ureter） in the observation group had renal colic again after the treatment ,and 13 ca‐ses took acesodyne .54 cases （40 cases in middle or upper parts of ureter and 14 cases in lower part of ureter ） in the control group developed renal colic （P〈0 .05） and 30 cases took acesodyne （P〈0 .05） .The severity o
出处
《现代泌尿外科杂志》
CAS
2015年第9期645-648,共4页
Journal of Modern Urology
