中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2015年
14期
2699-2702
,共4页
邓青富%朱永生%粟宏伟%裴利军%王娟
鄧青富%硃永生%粟宏偉%裴利軍%王娟
산청부%주영생%속굉위%배리군%왕연
输尿管结石%α 肾上腺素受体阻滞剂%坦索罗辛%药物排石治疗
輸尿管結石%α 腎上腺素受體阻滯劑%坦索囉辛%藥物排石治療
수뇨관결석%α 신상선소수체조체제%탄색라신%약물배석치료
Ureteral calculi%α-adrenoceptor antagonist%Tamsulosin%Medical expulsive therapy
目的：评估α1受体阻滞剂对7 mm以下的输尿管上段结石的辅助药物排石的临床疗效。方法将64例纳入研究的输尿管上段结石患者随机分成两组。A组患者接受黄体酮肌肉注射20 mg/d，双氯芬酸钠缓释胶囊100 mg/d，肾石通丸4.0 g/d治疗，B组在A组的基础上加用坦索罗辛0.4 mg/d治疗。每周随访一次，到结石排出为止共持续4周。比较两组患者在年龄、性别、结石大小、结石排出率、排出时间、肾绞痛的缓解率、需要住院观察的病例数之间的差异。结果两组患者在年龄、性别和结石直径上无统计学差异（P＞0.05）。总排石率为50%（31/62），B组排石率显著高于A组[54.84%（17/31）vs.45.16%（14/31）]，两组有统计学差异（P＜0.05）。B组结石平均排出时间为（11±4.2）d，A组为（15±3.4）d，两者比较具有统计学差异（P＜0.05）。B组肾绞痛缓解率为77.42%（24/31），A组为58.06%（18/31），两组在肾绞痛的缓解率上具有统计学差异（P＜0.05）。两组在因出现尿路感染、肾绞痛加剧、肾积水加重等情况而住院进一步治疗的人数上也具有统计学差异（P＜0.05），其中A组为8例，占25.81%（8/31），B组为3例，占9.68%（3/31）。结论α受体阻滞剂能有效辅助药物排石，提高输尿管上段结石患者的排石率，缩短排石时间，减轻肾绞痛症状及发作次数，降低住院率。
目的：評估α1受體阻滯劑對7 mm以下的輸尿管上段結石的輔助藥物排石的臨床療效。方法將64例納入研究的輸尿管上段結石患者隨機分成兩組。A組患者接受黃體酮肌肉註射20 mg/d，雙氯芬痠鈉緩釋膠囊100 mg/d，腎石通汍4.0 g/d治療，B組在A組的基礎上加用坦索囉辛0.4 mg/d治療。每週隨訪一次，到結石排齣為止共持續4週。比較兩組患者在年齡、性彆、結石大小、結石排齣率、排齣時間、腎絞痛的緩解率、需要住院觀察的病例數之間的差異。結果兩組患者在年齡、性彆和結石直徑上無統計學差異（P＞0.05）。總排石率為50%（31/62），B組排石率顯著高于A組[54.84%（17/31）vs.45.16%（14/31）]，兩組有統計學差異（P＜0.05）。B組結石平均排齣時間為（11±4.2）d，A組為（15±3.4）d，兩者比較具有統計學差異（P＜0.05）。B組腎絞痛緩解率為77.42%（24/31），A組為58.06%（18/31），兩組在腎絞痛的緩解率上具有統計學差異（P＜0.05）。兩組在因齣現尿路感染、腎絞痛加劇、腎積水加重等情況而住院進一步治療的人數上也具有統計學差異（P＜0.05），其中A組為8例，佔25.81%（8/31），B組為3例，佔9.68%（3/31）。結論α受體阻滯劑能有效輔助藥物排石，提高輸尿管上段結石患者的排石率，縮短排石時間，減輕腎絞痛癥狀及髮作次數，降低住院率。
목적：평고α1수체조체제대7 mm이하적수뇨관상단결석적보조약물배석적림상료효。방법장64례납입연구적수뇨관상단결석환자수궤분성량조。A조환자접수황체동기육주사20 mg/d，쌍록분산납완석효낭100 mg/d，신석통환4.0 g/d치료，B조재A조적기출상가용탄색라신0.4 mg/d치료。매주수방일차，도결석배출위지공지속4주。비교량조환자재년령、성별、결석대소、결석배출솔、배출시간、신교통적완해솔、수요주원관찰적병례수지간적차이。결과량조환자재년령、성별화결석직경상무통계학차이（P＞0.05）。총배석솔위50%（31/62），B조배석솔현저고우A조[54.84%（17/31）vs.45.16%（14/31）]，량조유통계학차이（P＜0.05）。B조결석평균배출시간위（11±4.2）d，A조위（15±3.4）d，량자비교구유통계학차이（P＜0.05）。B조신교통완해솔위77.42%（24/31），A조위58.06%（18/31），량조재신교통적완해솔상구유통계학차이（P＜0.05）。량조재인출현뇨로감염、신교통가극、신적수가중등정황이주원진일보치료적인수상야구유통계학차이（P＜0.05），기중A조위8례，점25.81%（8/31），B조위3례，점9.68%（3/31）。결론α수체조체제능유효보조약물배석，제고수뇨관상단결석환자적배석솔，축단배석시간，감경신교통증상급발작차수，강저주원솔。
Objective To assess the clinic effect of α1-adrenoceptor antagonist facilitating the medical expulsive therapy for single upper ureteral calculi within 7 mm. Methods All eligible patients diagnosed as upper ureteral calculi were randomized into two group: goup A (n=32, progesterone intramuscular injection 20 mg per day, Diclofenac Sodium Sustained Release Capsules 100 mg per day, Shen Shi Tong 4.0 g per day) and group B (n=32, 0.4 mg tamsulosin once a day on the basis of group A). Patients were evaluated every one week until stone expulsion or up to four weeks. The differences were compared in aging, gender, stone size, stone passage rate (SPR), stone expulsion time, remission rate of renal colic, the number of patients needing to be hospitalized. Results There were no significant differences in aging, gender, stone size (P>0.05). The cumulative SPR of the whole cohort was 50%(31/62). The SPR of group B was significantly higher than group A [54.84% (17/31) vs. 45.16% (14/31), P=0.026<0.05]. The stone expulsion time in group B was (11±4.2)d, while A was (15±3.4)d. There was significant difference between the two group. There also was significantly difference in the number of patients needing to be hospitalized as result of urinary tract infection, severe renal colic, enhanced hydronephrosis. The number of patients needing to be hospitalized in group B and A was 9.68% (3/31) and 25.81% (8/31) respectively. Conclusion α-adrenoceptor antagonists may facilitate medical expulsive therapy to enhance the SPR of upper ureteral calculi efficiently, minimize the stone expulsion time, alleviate the degree and frequency of renal colic, reduce hospitalization rates.
