α_1受体阻滞剂辅助治疗提高ESWL后上尿路结石清除率  

Alpha1-adrenergic blockers treatment increases clinical success rate of single extracorporeal shock wave lithotripsy of renal & ureteral calculi

作　　者：权伟合[1] 吴振启[1] 李虎宜[1] 梁志恒[1] 王凉梅[1] 

机构地区：[1]郧阳医学院附属东风医院泌尿外科,湖北十堰442008

出　　处：《临床泌尿外科杂志》2007年第3期210-212,共3页Journal of Clinical Urology

摘　　要：目的:证实上尿路结石在ESWL治疗后口服α1受体阻滞剂坦索洛辛0.2mg/d能否增加结石清除率。方法:将符合条件的120例患者按结石的部位随机分成三组,在ESWL治疗后再分成两组,一组给予常规治疗作为对照,另一组除给予常规治疗外,增加坦索洛辛0.2mg/d,持续1个月,将随访1个月和采取ESWL以外的治疗方法作为每位患者的研究终点。每个患者分别在治疗1、2、3、4周末通过B超或KUB了解结石排出情况。结果:把所有研究的患者按结石部位分成肾盂结石组、输尿管上段结石组和输尿管下段结石组。在治疗组中,结石排出率分别为52.1%、72.7%和76%,明显高于对照组的33.3%、36.3%和39.1%。在治疗后,两组肾绞痛的发生率亦有显著差异,因而对于镇痛剂的需求也明显不同(P<0.005)。结论:ESWL治疗上尿路结石后联合坦索洛辛0.2mg/d可以提高结石清除率,同时减少了镇痛剂的使用量和多次ESWL的几率。Objective：To evaluate whether alpha1-adrenergic blockers have any impact on stone clearance in patients with renal and ureteral calculi who underwent shock wave lithotripsy. Methods：A total ot 120 patients underwent a single ESWL session to treat solitary radiopaque renal and ureteral stones （≤10 mm）. After ESWL,all patients were randomly assigned to receive our standard medical therapy alone （controls） or in association with alpha1-adrenergic blocker （tamsulosin 0.2 mg daily）for 4 weeks. Results： All patients were assigned to the groups： renal calculi, distal of ureteral calculi and close of ureteral calculi. The stone-free rate in treatment groups was 52. 1%,72.7%,76%versus 33.3%,36.3% ,39.1% in control groups. During the treatment and follow-up period , 61.6 % of the patients reported episode of the flank pain：38.3 %in treatment group and 85 % in control group and with statistically significant difference between the two groups. Conclusions：The results of our study have demonstrated that alpha1-adrenergic blockers therapy , as an adjunctive medical therapy after ESWL, is more effective than lithotripsy alone for the treatment of patients with large renal and ureteral calculi. In addition ,our result also indicated that adjunctive treatment with alpha1-adrenergic blockers could decrease the use of analgesic drugs after ESWL.

关 键 词：上尿路结石 Α1受体阻断剂 体外冲击波碎石 

分 类 号：R691.4[医药卫生—泌尿科学]