CAJ | 학술논문

目的：探讨宁泌泰联合坦索罗辛治疗输尿管镜钬激光碎石术后留置双J管患者的临床疗效。方法选择本院2010年1月至2013年1月收治的行输尿管镜钬激光碎石术的患者117例，患者术后均留置双J管，按使用药物的不同分组：单用坦索罗辛组（30例），术后服用α1受体阻滞剂坦索罗辛每日1次，每次0.4 mg；单用宁泌泰组（29例），术后服用宁泌泰每日3次，每次1.52 g；坦索罗辛组联合宁泌泰（联合用药组，30例），术后给予坦索罗辛联合宁泌泰，手术对照组（28例），两种药物都不应用。术后约3 d拔除尿管，保留双J管1个月，3组用药时间均为1个月，评估各组患者不同泌尿系统症状分级、疼痛指数分级患者数及肉眼血尿发生率。结果3种不同治疗方法改善症状分级（χ2＝22.038，P＝0.000）、疼痛指数分级（χ2＝9.876，P＝0.020）、血尿（χ2＝8.000，P＝0.046）患者数方面比较差异均有统计学意义，联合用药组无症状和轻度症状分级患者数较坦索罗辛组、宁泌泰组、手术对照组明显增多（无症状：14比6、3、2例，轻度：13比9、5、4例），疼痛指数分级＞Ⅱ度患者数（7比9、14、17例）、血尿发生率〔26.6%（8/30）比56.7%（17/30）、58.6%（17/29）、53.6%（15/28）〕均较坦索罗辛组、宁泌泰组、手术对照组减少。坦索罗辛和宁泌泰联合用药在改善症状方面具有协同增强效应，在减轻疼痛发生率方面较单用坦索罗辛更有优势，并可降低并发症的发生率。结论宁泌泰联合坦索罗辛可有效预防双J管综合征。
목적：탐토저비태연합탄색라신치료수뇨관경화격광쇄석술후류치쌍J관환자적림상료효。방법선택본원2010년1월지2013년1월수치적행수뇨관경화격광쇄석술적환자117례，환자술후균류치쌍J관，안사용약물적불동분조：단용탄색라신조（30례），술후복용α1수체조체제탄색라신매일1차，매차0.4 mg；단용저비태조（29례），술후복용저비태매일3차，매차1.52 g；탄색라신조연합저비태（연합용약조，30례），술후급여탄색라신연합저비태，수술대조조（28례），량충약물도불응용。술후약3 d발제뇨관，보류쌍J관1개월，3조용약시간균위1개월，평고각조환자불동비뇨계통증상분급、동통지수분급환자수급육안혈뇨발생솔。결과3충불동치료방법개선증상분급（χ2＝22.038，P＝0.000）、동통지수분급（χ2＝9.876，P＝0.020）、혈뇨（χ2＝8.000，P＝0.046）환자수방면비교차이균유통계학의의，연합용약조무증상화경도증상분급환자수교탄색라신조、저비태조、수술대조조명현증다（무증상：14비6、3、2례，경도：13비9、5、4례），동통지수분급＞Ⅱ도환자수（7비9、14、17례）、혈뇨발생솔〔26.6%（8/30）비56.7%（17/30）、58.6%（17/29）、53.6%（15/28）〕균교탄색라신조、저비태조、수술대조조감소。탄색라신화저비태연합용약재개선증상방면구유협동증강효응，재감경동통발생솔방면교단용탄색라신경유우세，병가강저병발증적발생솔。결론저비태연합탄색라신가유효예방쌍J관종합정。
Objective To investigate the clinical outcomes derived from Ningmitai combined with tamsulosin to prevent double-J stent syndrome after laser lithotripsy with ureteroscope. Methods 117 patients underwent laser lithotripsy with ureteroscope and then placed a double-J stent for draining were collected from January 2010 to January 2013. Patients with double-J stent placement were divided into four groups determined by dosage regimen. Tamsulosin group (30 cases) was treated with tamsulosin (0.4 mg once daily) lonely, Ningmitai group (29 cases) was treated with Ningmitai (1.52 g, trice time a day) lonely, tamsulosin combined Ningmitai group (30 cases) was treated with tamsulosin and Ningmitai at the same time, operation control group (28 cases) was neither tamsulosin nor Ningmitai. The catheter was removed on the 3rd day post-lithotripsy and then remained double-J stent for 1 month. The scores of urinary tract, pain and the incidence of gross hematuria were assessed. Results The significant differences in the improvement of symptom score (χ2=22.038, P=0.000), pain score (χ2=9.876, P=0.020) and hematuria (χ2=8.000, P=0.046) were found among tamsulosin group, Ningmitai group, and tamsulosin combined Ningmitai group. The number of patients with symptomless, slight symptom in tamsulosin combined Ningmitai group were higher than those of tamsulosin group, Ningmitai group, operation control group (symptomeless:14 vs. 6, 3 and 2 cases;slight symptom:13 vs. 9, 5, 4 cases). The number of patients with>Ⅱpain score (7 vs. 9, 14, 17 cases) and incidence of hematuriag [26.6%(8/30) vs. 56.7%(17/30), 58.6% (17/29), 53.6% (15/28)] were lower in tamsulosin combined Ningmitai group than those of tamsulosin group, Ningmitai group, operation control group. The drug combination of Ningmitai with tamsulosin had the synergism to relived symptom and pain, and showed the more obviousthan lonely use. Conclusion The drug combination of Ningmitai with tamsulosin can be used in clinic for prophylactic purpose to prevent double-J syndrome.