中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
8期
6-9
,共4页
杜科霖%欧阳骏%樊彩斌%温端改
杜科霖%歐暘駿%樊綵斌%溫耑改
두과림%구양준%번채빈%온단개
肾上腺素能α拮抗剂%碎石术%输尿管结石
腎上腺素能α拮抗劑%碎石術%輸尿管結石
신상선소능α길항제%쇄석술%수뇨관결석
Adrenergic alpha-antagonists%Lithotripsy%Ureteral calculi
目的 探讨高选择性α1受体阻滞剂在输尿管结石体外冲击波碎石术(ESWL)术后辅助治疗中的临床应用价值.方法 将120例输尿管结石采用ESWL治疗后的患者按随机数字表法分为三组,每组40例.坦索罗辛组给予高选择性α1受体阻滞剂坦索罗辛0.4 mg,1次/d;多沙唑嗪组给予选择性α1受体阻滞剂多沙唑嗪4 mg,1次/d;对照组为空白对照组,未给予任何输尿管平滑肌松弛剂.每例患者的观察时间为2周.结果 共有4例患者因药物不良反应而退出.坦索罗辛组、多沙唑嗪组的排石率[分别为89.7%(35/39)、83.8%(31/37)]均明显高于对照组[65.0%(26/40)](P＜0.05);排石时间[分别为(3.1±1.2)、(3.7±1.4)d]均明显短于对照组[(6.5±1.1)d](P＜0.05);肾绞痛发生率[分别为12.8%(5/39)、21.6%(8/37)]、石街形成率[分别为7.7%(3/39)、13.5%(5/37)]均明显低于对照组[45.0%(18/40)和40.0%(16/40)](P＜0.05).坦索罗辛组和多沙唑嗪组临床疗效比较差异无统计学意义(P＞0.05).坦索罗辛组中仅1例患者出现体位性低血压,多沙唑嗪组7例患者出现体位性低血压,两组比较差异有统计学意义(P＜0.05).结论 输尿管结石ESWL术后使用高选择性α1受体阻滞剂辅助治疗有助于结石的排出,明显缩短排石时间,减少肾绞痛发生率,且安全,患者可以耐受,可推荐作为输尿管结石ESWL术后的辅助排石方法.
目的 探討高選擇性α1受體阻滯劑在輸尿管結石體外遲擊波碎石術(ESWL)術後輔助治療中的臨床應用價值.方法 將120例輸尿管結石採用ESWL治療後的患者按隨機數字錶法分為三組,每組40例.坦索囉辛組給予高選擇性α1受體阻滯劑坦索囉辛0.4 mg,1次/d;多沙唑嗪組給予選擇性α1受體阻滯劑多沙唑嗪4 mg,1次/d;對照組為空白對照組,未給予任何輸尿管平滑肌鬆弛劑.每例患者的觀察時間為2週.結果 共有4例患者因藥物不良反應而退齣.坦索囉辛組、多沙唑嗪組的排石率[分彆為89.7%(35/39)、83.8%(31/37)]均明顯高于對照組[65.0%(26/40)](P＜0.05);排石時間[分彆為(3.1±1.2)、(3.7±1.4)d]均明顯短于對照組[(6.5±1.1)d](P＜0.05);腎絞痛髮生率[分彆為12.8%(5/39)、21.6%(8/37)]、石街形成率[分彆為7.7%(3/39)、13.5%(5/37)]均明顯低于對照組[45.0%(18/40)和40.0%(16/40)](P＜0.05).坦索囉辛組和多沙唑嗪組臨床療效比較差異無統計學意義(P＞0.05).坦索囉辛組中僅1例患者齣現體位性低血壓,多沙唑嗪組7例患者齣現體位性低血壓,兩組比較差異有統計學意義(P＜0.05).結論 輸尿管結石ESWL術後使用高選擇性α1受體阻滯劑輔助治療有助于結石的排齣,明顯縮短排石時間,減少腎絞痛髮生率,且安全,患者可以耐受,可推薦作為輸尿管結石ESWL術後的輔助排石方法.
목적 탐토고선택성α1수체조체제재수뇨관결석체외충격파쇄석술(ESWL)술후보조치료중적림상응용개치.방법 장120례수뇨관결석채용ESWL치료후적환자안수궤수자표법분위삼조,매조40례.탄색라신조급여고선택성α1수체조체제탄색라신0.4 mg,1차/d;다사서진조급여선택성α1수체조체제다사서진4 mg,1차/d;대조조위공백대조조,미급여임하수뇨관평활기송이제.매례환자적관찰시간위2주.결과 공유4례환자인약물불량반응이퇴출.탄색라신조、다사서진조적배석솔[분별위89.7%(35/39)、83.8%(31/37)]균명현고우대조조[65.0%(26/40)](P＜0.05);배석시간[분별위(3.1±1.2)、(3.7±1.4)d]균명현단우대조조[(6.5±1.1)d](P＜0.05);신교통발생솔[분별위12.8%(5/39)、21.6%(8/37)]、석가형성솔[분별위7.7%(3/39)、13.5%(5/37)]균명현저우대조조[45.0%(18/40)화40.0%(16/40)](P＜0.05).탄색라신조화다사서진조림상료효비교차이무통계학의의(P＞0.05).탄색라신조중부1례환자출현체위성저혈압,다사서진조7례환자출현체위성저혈압,량조비교차이유통계학의의(P＜0.05).결론 수뇨관결석ESWL술후사용고선택성α1수체조체제보조치료유조우결석적배출,명현축단배석시간,감소신교통발생솔,차안전,환자가이내수,가추천작위수뇨관결석ESWL술후적보조배석방법.
Objective To investigate the application of highly selective alpha 1-blockers in treatment of ureteral stone after extracorporeal shock wave lithotripsy (ESWL). Methods One hundred and twenty patients with ureteral stone who accepted ESWL were divided into three groups by random digits table,each 40 cases. Tamsulosin group received tamsulosin (0.4 mg,once daily) after ESWL,doxazosin group received doxazosin (4 mg,once daily) ,control group were given no ureteral smooth musclar relaxant served. All patients were observed for 2 weeks. Results During the 2 weeks, only 4 patients withdrew due to adverse drug reactions. In tamsulosin group and doxazosin group, the stones expulsion rate [89.7%(35/39), 83.8%(31/37) respectively] were significantly higher than control group [65.0%(26/40)] (P＜0.05), the expulsion time [(3.1-1.2), (3.7 ± 1.4) d] were significantly lower than control group [(6.5 ±1.1) d] (P ＜0.05),the incidence of renal colic [12.8%(5/39), 21.6%(8/37)] and the stone street formation rate [7.7% (3/39), 13.5% (5/37)] were significantly lower than control group [45.0% (18/40) and 40.0% (16/40)] (P ＜ 0.05). But there was no significant difference between tamsulosin group and doxazosin group (P ＞ 0.05). Orthostatic hypotension occurred in 1 patient in tamsulosin group, but 7 patients experienced orthostatic hypotension in doxazosin group,the difference was significant (P ＜ 0.05).Conclusions Highly selective alpha 1-blockers can improve the stone-free rate of ureteral stone after ESWL,reduce expulsion time,decrease renal colic rate,and it is safe and tolerated. It can be regarded as an auxiliary clearance method after ESWL for ureteral stone.
