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目的探讨体外冲击波碎石(ESWL)治疗较大输尿管下段结石术后应用坦索罗辛,对于提高结石清除率的有效性与安全性。方法应用随机对照的临床试验方法,对80例较大输尿管下段结石(直径大于10mm)的患者进行了为期4周的观察,在接受首次ESWL治疗后,对照组(n=40)接受保守治疗,治疗组(n=40)除保守治疗外,每日服用坦索罗辛0.4mg。结果首次ESWL后2周随访末,治疗组的结石清除率(82.5%,33/40)显著高于对照组(52.5%,21/40)(P<0.05),期间绞痛平均次数及平均VAS评分显著低于对照组。第二次ESWL后2周末随访,治疗组的结石清除率(95%,38/40),显著高于对照组(62.5%,25/40)(P<0.05)。结论 ESWL后应用坦索罗辛,可以显著提高较大输尿管下段结石清除率及治疗效率,而且可以减轻术后绞痛,不良反应发生率低。
Objective To investigate the efficacy and safety of extracorporeal shock wave lithotripsy (ESWL) in the treatment of large ureteral calculi after tamsulosin treatment for improving stone clearance rate. Methods A randomized controlled clinical trial was conducted in 80 patients with large ureteral stones (diameter> 10mm) for 4 weeks. After receiving ESWL for the first time, the control group (n = 40) received conservative treatment, The treatment group (n = 40) received tamsulosin 0.4 mg daily except for conservative treatment. Results The stone clearance rate (82.5%, 33/40) in the treatment group was significantly higher than that in the control group (52.5%, 21/40) (P <0.05) at the end of 2 weeks after the first ESWL. The mean number of colic and mean VAS The scores were significantly lower than the control group. After the second ESWL followed up for 2 weeks, the stone clearance rate (95%, 38/40) in the treatment group was significantly higher than that in the control group (62.5%, 25/40) (P <0.05). Conclusion The application of tamsulosin after ESWL can significantly improve the removal rate and treatment efficiency of the larger ureteral stones, and can reduce postoperative colic, the incidence of adverse reactions is low.