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目的:探讨坦索罗辛联合热淋清对输尿管下段结石ESWL后辅助排石和缓解疼痛的疗效。方法:将420例单发输尿管下段结石ESWL后患者随机分为四组,每组105例。结石直径5~16mm。所有患者采用B超定位下ESWL治疗后,对照组除适度增加饮水外不采取任何辅助排石措施;热淋清组口服热淋清颗粒16g,每天3次;坦索罗辛组口服盐酸坦索罗辛0.2mg,每天1次;联合组口服热淋清颗粒16g,每天3次,盐酸坦索罗辛0.2mg,每天1次。所有患者治疗观察2周。结果:ESWL后2周根据影像学检查结果评估各组结石排净率,对照组为81.9%,热淋清组为86.7%,坦索岁辛组为92.4%,联合组为96.2%。热淋清组、坦索罗辛组、联合组与对照组比较,差异均有统计学意义(P<0.05)。联合组与其余三组相比,差异也有统计学意义(P<0.05)。治疗期间肾绞痛的平均发作率对照组为41.9%,热淋清组为34.3%,坦索罗辛组为18.1%,联合组为4.0%。热淋清组与对照组比较,差异无统计学意义(P>0.05)。坦索罗辛组及联合组与对照组及热淋清组比较,差异有统计学意义(P<0.05)。排石时间对照组(8.2±3.3)d,热淋清组(6.4±2.2)d,坦索罗辛组(4.9±2.5)d,联合组(3.7±1.8)d。后三组与对照组比较,差异均有统计学意义(P<0.05)。结论:输尿管下段结石行ESWL后应用坦索罗辛和热淋清辅助排石安全有效,能显著提高结石排出率,减少治疗期间肾绞痛发生率,缩短排石时间。
Objective: To investigate the effect of tamsulosin combined with Pyridoxyl on the assisted drainage and pain relief after ESWL in lower ureteral calculi. Methods: 420 patients with single ureteral calculi under ESWL were randomly divided into four groups, 105 cases in each group. Stone diameter 5 ~ 16mm. All patients underwent B-ultrasonography after ESWL treatment, the control group in addition to moderate increase in drinking water without taking any auxiliary row of stone measures; heat rash group oral rehydration particles 16g, 3 times a day; tamsulosin group oral tamsulosin hydrochloride Rosin 0.2mg, 1 times a day; combination group oral heat clearing clear particles 16g, 3 times a day, tamsulosin hydrochloride 0.2mg, 1 day. All patients were treated for 2 weeks. Results: The rate of stone removal in each group was evaluated according to the results of imaging examination two weeks after ESWL. The control group was 81.9%, the heat rash group 86.7%, the tamsulosin group 92.4% and the combined group 96.2%. Heat rash group, tamsulosin group, the combination group and the control group, the differences were statistically significant (P <0.05). Compared with the other three groups, the difference between the two groups was also statistically significant (P <0.05). The mean incidence of renal colic during treatment was 41.9% in the control group, 34.3% in the heat-clearing group, 18.1% in the tamsulosin group, and 4.0% in the combination group. Heat rash group and control group, the difference was not statistically significant (P> 0.05). Tamsulosin group and the combination group with the control group and the heat rash group, the difference was statistically significant (P <0.05). (6.2 ± 3.3) days in pyrolusate group, 6.4 ± 2.2 days in pyrex group, 4.9 ± 2.5 days in tamsulosin group and 3.7 ± 1.8 days in combination group. After the three groups compared with the control group, the differences were statistically significant (P <0.05). Conclusion: It is safe and effective to use tamsulosin and heat-clearing-assisted paving stones after ESWL for lower ureteral stones, which can significantly improve the rate of stone excretion, reduce the incidence of renal colic during treatment and shorten the time of stone discharging.