坦索罗辛在较大输尿管下段结石ESWL后辅助排石疗效观察.docVIP

坦索罗辛在较大输尿管下段结石ESWL后辅助排石疗效观察【摘要】 目的 探讨体外冲击波碎石(ESWL)治疗较大输尿管下段结石术后应用坦索罗辛，对于提高结石清除率的有效性与安全性。方法 应用随机对照的临床试验方法，对80例较大输尿管下段结石(直径大于10 mm)的患者进行了为期4周的观察，在接受首次ESWL治疗后，对照组(n=40)接受保守治疗，治疗组(n=40)除保守治疗外，每日服用坦索罗辛0.4 mg。结果 首次ESWL后2周随访末，治疗组的结石清除率(82.5%，33/40)显著高于对照组(52.5%，21/40)(P 4 结论? 应用高选择性α??1A/D肾上腺素能受体抗结剂坦索罗辛(每日0.4 mg)，可以显著提高ESWL治疗较大输尿管下段结石的成功率及治疗效率。在4周的临床应用中不良反应轻微。而且坦索罗辛结合保守治疗可以减轻ESWL术后结石碎片引起的绞痛。因此，建议在ESWL治疗较大(10 mm以上)输尿管下段结石的过程中，应用坦索罗辛作为ESWL术后辅助治疗。? 参考文献? ［1］Kupeli B, Irkilata L, Gurocak S D, et al. Does tamsulosin enhance lower ureteral stone clearance with or without shock wave lithotripsy?Urology,2004,64:1111-1115.? ［2］Resim S, Ekerbicer H C, Ciftci A. Role of tamsulosin in treatment of patients with steinstrasse developing after extracorporeal shock wave lithotripsy.Urology,2005,66:945-948.? ［3］Dellabella M, Milanese G. Muzzonigro G Randomized trial of the efficacy of tamsulosin,nifedipine and phloroglucinol in medical expulsive therapy for distal ureteral calculi.J Urol,2005,174:167-172.? ［4］Autorino R, Desio M, Damiano R, et al. The use of tamsulosin in the medical treatment of ureteral calculi: where do we stand?Urol Res,2005,33:460-464.? ［5］Bhagat S K, Chacko N K,Kekre N S, et al. Is there a role for tamsulosin in shock wave lithotripsy for renal and ureteral calculi?J Urol,2007,177:2185-2188.? ［6］Agarwal M M, Naja V, Singh S K, et al. Is there an adjunctive role of tamsulosin to extracorporeal shockwave lithotripsy for upper ureteric stones: results of an open label randomized nonplacebo controlled study.Urology,2009,74:989-993. 注：本文中所涉及到的图表、注解、公式等内容请以PDF格式阅读原文 1