国际泌尿系统杂志
國際泌尿繫統雜誌
국제비뇨계통잡지
International Journal of Urology and Nephrology
2015年
5期
700-702
,共3页
输尿管结石%碎石术
輸尿管結石%碎石術
수뇨관결석%쇄석술
Ureteral Calculi%Lithotripsy
目的 探讨坦索罗辛和索利那新在缩短输尿管软镜碎石术前双J管病例预置时间中的作用及其缓解症状中的疗效.方法 2008年11月～2013年12月两个中心共收治行输尿管软镜的肾结石患者137例,男85例,女47例,年龄16 ～79岁,采用留置双J管行被动扩张后二期行软镜碎石术.随机分为3组,坦索罗辛联合索利那新1周组(A组46例),口服索利那新5mg,1次/d、坦索罗辛0.2mg,1次/d联合双J管被动扩张1周后手术;坦索罗辛联合索利那新2周组(B组46例),口服索利那新5mg,1次/d、坦索罗辛0.2mg,1次/d联合双J管被动扩张2周后手术;对照组仅采用留置双J管被动扩张2周(C组45例).以USSQ评分评估扩张期间患者置管相关症状.所有患者二期手术中采用F14外径UAS行软镜手术,以UAS肾盂抵达肾盂为置入成功标准.结果 置管7d后,A、B两组USSQ明显低于对照组(P＜0.05).A、B及C组使用镇痛药物患者分别为4、3、11例,发生膀胱刺激征患者分别为3、2、12例,各组间比较差异均有统计学意义(P＜0.05).A、B及C组二期手术中UAS置入成功率分别为95.6％、100％及100％,AB两组间相比差异无统计学意义(P＞0.05),但两组较对照组差异均有统计学意义(P＜0.05).结论 对于采用双J管行被动扩张的患者,使用坦索罗辛和索利那新不仅可以有效缓解患者症状,而且可以明显缩短置管时间,值得推广.
目的 探討坦索囉辛和索利那新在縮短輸尿管軟鏡碎石術前雙J管病例預置時間中的作用及其緩解癥狀中的療效.方法 2008年11月～2013年12月兩箇中心共收治行輸尿管軟鏡的腎結石患者137例,男85例,女47例,年齡16 ～79歲,採用留置雙J管行被動擴張後二期行軟鏡碎石術.隨機分為3組,坦索囉辛聯閤索利那新1週組(A組46例),口服索利那新5mg,1次/d、坦索囉辛0.2mg,1次/d聯閤雙J管被動擴張1週後手術;坦索囉辛聯閤索利那新2週組(B組46例),口服索利那新5mg,1次/d、坦索囉辛0.2mg,1次/d聯閤雙J管被動擴張2週後手術;對照組僅採用留置雙J管被動擴張2週(C組45例).以USSQ評分評估擴張期間患者置管相關癥狀.所有患者二期手術中採用F14外徑UAS行軟鏡手術,以UAS腎盂牴達腎盂為置入成功標準.結果 置管7d後,A、B兩組USSQ明顯低于對照組(P＜0.05).A、B及C組使用鎮痛藥物患者分彆為4、3、11例,髮生膀胱刺激徵患者分彆為3、2、12例,各組間比較差異均有統計學意義(P＜0.05).A、B及C組二期手術中UAS置入成功率分彆為95.6％、100％及100％,AB兩組間相比差異無統計學意義(P＞0.05),但兩組較對照組差異均有統計學意義(P＜0.05).結論 對于採用雙J管行被動擴張的患者,使用坦索囉辛和索利那新不僅可以有效緩解患者癥狀,而且可以明顯縮短置管時間,值得推廣.
목적 탐토탄색라신화색리나신재축단수뇨관연경쇄석술전쌍J관병례예치시간중적작용급기완해증상중적료효.방법 2008년11월～2013년12월량개중심공수치행수뇨관연경적신결석환자137례,남85례,녀47례,년령16 ～79세,채용류치쌍J관행피동확장후이기행연경쇄석술.수궤분위3조,탄색라신연합색리나신1주조(A조46례),구복색리나신5mg,1차/d、탄색라신0.2mg,1차/d연합쌍J관피동확장1주후수술;탄색라신연합색리나신2주조(B조46례),구복색리나신5mg,1차/d、탄색라신0.2mg,1차/d연합쌍J관피동확장2주후수술;대조조부채용류치쌍J관피동확장2주(C조45례).이USSQ평분평고확장기간환자치관상관증상.소유환자이기수술중채용F14외경UAS행연경수술,이UAS신우저체신우위치입성공표준.결과 치관7d후,A、B량조USSQ명현저우대조조(P＜0.05).A、B급C조사용진통약물환자분별위4、3、11례,발생방광자격정환자분별위3、2、12례,각조간비교차이균유통계학의의(P＜0.05).A、B급C조이기수술중UAS치입성공솔분별위95.6％、100％급100％,AB량조간상비차이무통계학의의(P＞0.05),단량조교대조조차이균유통계학의의(P＜0.05).결론 대우채용쌍J관행피동확장적환자,사용탄색라신화색리나신불부가이유효완해환자증상,이차가이명현축단치관시간,치득추엄.
Objectives To evaluate the efficacy of combination of solifenacin and tamsulosin for the passive ureteral dilation for ureteral access sheath (UAS) placement with preoperative stenting (POS).Methods 137 patients (male:85,female:47 age:16 ～ 79 yrs) randomly assigned to 3 groups.The solifenacin group were administered solifenacin 5 mg,once per day.The combination group 1 (Group A of 46 cases) were administered solifenacin 5mg,plus tamsulosin 0.2 mg,each per day after with preoperative stenting for 7 days.The combination group 2 (Group B of 46 cases) were administered solifenacin 5mg,plus tamsulosin 0.2 mg,each per day after with preoperative stenting for 2 weeks.The control group was placed with stenting without administering any medicine.The observation duration was set at 1 weeks using ureteral stent symptoms questionnaire(USSQ).The analgesic requirements,successful rate of UAS insertion and rate of ureteral injury were also recorded.Results Seven days after stent placement,analysis of the USSQ showed a significant worsening of scores in all domains in patients not receiving solifenacin plus tamsulosin (Group A&B vs.C,P ＜ 0.05).No patients experienced clinical significant side effects from solifenacin plus tamsulosin.The successful rate of UAS placement was significantly higher in group A than in group C (P ＜ 0.05),but was not significantly different when compared with group B.The rate of ureteral injury was significantly lower in group A&B than in group C(P ＜0.05).The grade of injury was also lower in group A&B than group C.Statistical differences were also significant for the use of analgesics and relief of bladder irritation between the group C and group A&B.Conclusions Tamsulosin and solifenacin could be safe and effective for relieving of preoperative stenting related symptoms and shorten the passive dilation duration without compromise its result.
