国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2013年
21期
3313-3316
,共4页
解痉药物%输尿管损伤%输尿管镜
解痙藥物%輸尿管損傷%輸尿管鏡
해경약물%수뇨관손상%수뇨관경
Anticonvulsive drug%Ureteral injury%Ureteroscope
目的 探讨术前使用输尿管解痉药物在输尿管镜取石术中的临床价值.方法 将252例输尿管结石患者随机分为5组,A组50例为对照组；B组51例,给予间苯三酚80 mg/天,静滴；C组50例,给予α受体阻滞剂(坦索罗辛)0.4 mg/天,口服；D组49例,给予山莨菪碱10 ng,2次/天,静滴；E组52例,给予黄体酮40mg/天,肌注.解痉治疗3天后,采用wolf 8.0/9.8F硬性输尿管镜行输尿管镜下碎石取石术.结果 本组252例均获成功,结石清除率为98.8％(249/252),在输尿管镜进镜中,直视下进镜组E与组A、组D差异具有统计学意义,P＜ 0.05；而在导丝引导下仍未到达结石部位,组E与组A差异具有统计学意义,P＜ 0.05.在并发症发生率方面,组A与组B、组C、组D及组E相比,差异具有统计学意义,x 2=27.04,P=0.000,而组B、组C、组D及组E相比,差异无统计学意义,P＞ 0.05；术后随访3～ 18个月,平均9月,结石无复发,未见输尿管狭窄.结论 术前使用解痉药物能松弛输尿管平滑肌,使输尿管松弛和舒张,可显著降低术中输尿管损伤的发生率.以黄体酮的效果相对较好.
目的 探討術前使用輸尿管解痙藥物在輸尿管鏡取石術中的臨床價值.方法 將252例輸尿管結石患者隨機分為5組,A組50例為對照組；B組51例,給予間苯三酚80 mg/天,靜滴；C組50例,給予α受體阻滯劑(坦索囉辛)0.4 mg/天,口服；D組49例,給予山莨菪堿10 ng,2次/天,靜滴；E組52例,給予黃體酮40mg/天,肌註.解痙治療3天後,採用wolf 8.0/9.8F硬性輸尿管鏡行輸尿管鏡下碎石取石術.結果 本組252例均穫成功,結石清除率為98.8％(249/252),在輸尿管鏡進鏡中,直視下進鏡組E與組A、組D差異具有統計學意義,P＜ 0.05；而在導絲引導下仍未到達結石部位,組E與組A差異具有統計學意義,P＜ 0.05.在併髮癥髮生率方麵,組A與組B、組C、組D及組E相比,差異具有統計學意義,x 2=27.04,P=0.000,而組B、組C、組D及組E相比,差異無統計學意義,P＞ 0.05；術後隨訪3～ 18箇月,平均9月,結石無複髮,未見輸尿管狹窄.結論 術前使用解痙藥物能鬆弛輸尿管平滑肌,使輸尿管鬆弛和舒張,可顯著降低術中輸尿管損傷的髮生率.以黃體酮的效果相對較好.
목적 탐토술전사용수뇨관해경약물재수뇨관경취석술중적림상개치.방법 장252례수뇨관결석환자수궤분위5조,A조50례위대조조；B조51례,급여간분삼분80 mg/천,정적；C조50례,급여α수체조체제(탄색라신)0.4 mg/천,구복；D조49례,급여산랑탕감10 ng,2차/천,정적；E조52례,급여황체동40mg/천,기주.해경치료3천후,채용wolf 8.0/9.8F경성수뇨관경행수뇨관경하쇄석취석술.결과 본조252례균획성공,결석청제솔위98.8％(249/252),재수뇨관경진경중,직시하진경조E여조A、조D차이구유통계학의의,P＜ 0.05；이재도사인도하잉미도체결석부위,조E여조A차이구유통계학의의,P＜ 0.05.재병발증발생솔방면,조A여조B、조C、조D급조E상비,차이구유통계학의의,x 2=27.04,P=0.000,이조B、조C、조D급조E상비,차이무통계학의의,P＞ 0.05；술후수방3～ 18개월,평균9월,결석무복발,미견수뇨관협착.결론 술전사용해경약물능송이수뇨관평활기,사수뇨관송이화서장,가현저강저술중수뇨관손상적발생솔.이황체동적효과상대교호.
Objective To explore clinical value of preoperative use of ureteral antispasmodic drugs in ureteroscopy lithotripsy.Methods 252 patients with ureteral calculus were randomly divided into five groups:Group A with 50 patients,as the control group; Group B,51 patients,were treated with Phloroglucinol (80 mg,ivgtt,once daily); Group C,50 patients,were treated with tamsulosin (0.4 mg,po,once daily),Group D,49 patients,were treated with 654-2 (10 mg,ivgtt,twice daily); Group E,52 patients,were treated with progesterone (40 mg,im,once daily).All groups were given anti-inflammatory treatment preoperatively.8.0/9.8 F rigid ureteroscope was used for ureteroscopic lithotomy or lithotripsy 3 days after antispasmodic treatment.Results The operation was successful in all cases.The overall stone-free rate was 98.8％(249/252).In the operation,there was statistical difference in using reteroscope under direct vision between group A and E (P ＜ 0.05).There were statistical differences in postoperative complication incidence between group A and B,C,D,E (P ＜ 0.05).After 3-18 months' (average 9 months) follow-up period,there was no recurrence and no ureterostenosis was found.Conclusions Routine preoperative use of antispasmodic drugs can relax ureteral smooth muscle,make the ureter relaxed and diastolic,and significantly lower the incidence of intraoperative ureteral injuries.The antispasmodic effect of progesterone is the best among several antispasmodic drugs,with few side effects.
