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目的评估高选择性α1受体阻滞剂坦索罗辛对肾结石体外震波碎石(ESWL)术后辅助排石作用的有效性及安全性。方法 140例单发的非下盏部位的肾结石患者,结石大小6～20mm,ESWL碎石成功后随机分为两组,每组70例。对照组给予标准治疗包括中成药尿石通丸及司帕沙星,试验组接受标准治疗基础上加用坦索罗辛,随访2个月。结果试验组(坦索罗辛组)单次ESWL后结石排出率、结石排出时间、石街形成率、肾绞痛发生次数及哌替啶的使用次数等指标均优于对照组(P值分别为0.009,0.000,0.028,0.012,0.002),但两组之间的结石排净率差异无统计学意义(P=0.125)。按结石大小进行分组分析,结石≥10mm患者中,坦索罗辛组的结石排净率高于对照组,差异有统计学意义(P=0.044),且其余各项指标均优于对照组(P<0.05)。结石<10mm者,坦索罗辛组仅结石排出时间与肾绞痛发生次数两项指标优于对照组(P=0.001,0.026)。坦索罗辛组药物副作用发生率与对照组相比差别无统计学意义(P=0.085),且症状轻微,无一例患者因副作用停止治疗。结论坦索罗辛能够促进并加快肾结石单次ESWL术后碎石排出,减少石街形成并降低肾绞痛发生频率及止痛针使用,对于≥10mm肾结石患者还能够提高结石排净率,用于辅助排石安全有效。
Objective To evaluate the efficacy and safety of tamsulosin, a highly selective α1 receptor antagonist, in post-operative pavement-assisted stone extraction of extracorporeal shock wave lithotripsy (ESWL) in kidney stones. Methods One hundred and forty patients with single kidney stones without luminosity were divided into two groups according to the size of stones: 6-20 mm. ESWL grafts were randomly divided into two groups (n = 70 in each group). The control group was given standard treatment including urolithiasis and sparfloxacin, the experimental group received standard treatment plus tamsulosin, followed up for 2 months. Results The indexes of stone discharge rate, stone discharge time, stone street formation rate, the incidence of renal colic and the number of use of pethidine in the test group (tamsulosin group) after single ESWL were better than those in the control group 0.009,0.000,0.028,0.012,0.002), but there was no significant difference between the two groups (P = 0.125). According to the size of the stones, the stone removal rate of tamsulosin group was higher than that of the control group, the difference was statistically significant (P = 0.044), and the rest of the indicators were better than the control group P <0.05). Stone <10mm, tamsulosin group only stone discharge time and the number of occurrence of renal colic two indicators better than the control group (P = 0.001,0.026). Tamsulosin group drug side effects compared with the control group, the difference was not statistically significant (P = 0.085), and mild symptoms, none of patients due to side effects to stop treatment. Conclusion Tamsulosin can promote and accelerate the gravel discharge after a single ESWL of renal calculi, reduce the formation of stone streets and reduce the incidence of renal colic and the use of analgesic needles. It can also improve the stone clearance rate for patients with kidney stone ≥10 mm, It is safe and effective for assisting row of stone.