α_1肾上腺素能受体阻滞剂在输尿管下段结石体外震波碎石后辅助排石中的应用  

Application of α_1-adrenergic Antagonist with Extracorporeal Shock Wave Lithotripsy for Lower Ureteral Stone

作　　者：王惠君[1] 刘可[1] 纪志刚[1] 李汉忠[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院泌尿外科,北京100730

出　　处：《中国医学科学院学报》2008年第4期506-508,共3页Acta Academiae Medicinae Sinicae

摘　　要：目的探讨α1肾上腺素能受体阻滞剂在输尿管下段结石体外震波碎石(ESWL)后辅助排石中的效果。方法80例输尿管下段结石患者随机分成对照组和治疗组,对照组ESWL后应用消炎痛25 mg,3次/d,排石颗粒5 g,3次/d,未应用输尿管平滑肌松弛剂;治疗组ESWL后在对照组治疗方案基础上予以口服α1肾上腺素能受体阻滞剂坦索罗辛0.4 mg,1次/d。观察结石排出情况、是否再次发生肾绞痛而需要镇痛药治疗和药物的副作用。每例患者观察时间不超过2周。结果对照组排石率为45.0%,治疗组排石率为77.5%,两组比较差异具有显著性(P<0.01)。两组再次发生肾绞痛而需要镇痛药治疗的患者分别为对照组20.0%和治疗组5.0%,两组比较差异具有显著性(P<0.05)。治疗组除2例发生头晕外,无其他不良反应发生,而对照组无不良反应发生。结论坦索罗辛能提高输尿管下段结石ESWL后的排石率,减少再发生肾绞痛的几率,且安全有效,可作为输尿管下段结石ESWL后的辅助排石方法。Objective To evaluate the efficacy of α1-adrenergic antagonist in the medical management of lower ureteral stone with extracorporeal shock wave lithotripsy（ESWL）.Methods A total of 80 patients with stone located in lower ureter were randomly divided into two groups.Group 1 served as control and group 2 received tamsulosin（0.4 mg,once daily） after ESWL.All patients were observed for 2 weeks and asked to compile a diary about renal colic,stone expulsion,use of analgesic drugs,and side effects of medical therapy.Results During 2 weeks,stones were expulsed in 18 patients（45.0%） of group 1 and in 31 patients（77.5%） of group 2.The expulsion rate between group 1 and group 2 was significantly different（P〈0.01）.Eight patients（20.0%） in group 1 and 2 patients（5.0%） in group 2 experienced renal colic relapse within 2 weeks and were administered with analgesics（P〈0.05）.No side effect in group 1 was reported,except that 2 patients in group 2 complained of slight dizziness.Conclusions Tamsulosin（α1-adrenergic antagonist） can improve the stone-free rate of lower ureteral stones after ESWL and reduce the relapse of renal colic.As a safe and effective agent,it can be regarded as an auxiliary clearance method after ESWL for lower ureteral stones.

关 键 词：输尿管结石 体外震波碎石 Α1肾上腺素能受体阻滞剂 

分 类 号：R693.4[医药卫生—泌尿科学]