坦索罗辛和山莨菪碱在输尿管下段结石辅助排石中作用应用.docVIP

坦索罗辛和山莨菪碱在输尿管下段结石辅助排石中作用应用 　　【摘要】 目的 分析坦索罗辛和654-2在输尿管下段结石辅助排石中疗效。方法 120例输尿管下段结石患者随机分3组，每组40例。结石直径0.4~0.8 cm。组1为对照组，未给予输尿管平滑肌松弛剂；组2给予654-2 10 mg,3次/d；组3给予坦索罗辛0.4 mg,1次/d。每例患者治疗观察期不超过2周。结果 2周内结石排出者组1为17例(42.5%)，组2为29例(72.5%)，组3为33例(82.5%)，组2、3与组1比较排石率差异有统计学意义(P0.05)。2周内组1~3因再次发生肾绞痛而需镇痛治疗者分别为12例(30%)、5例(12.5%)和1例(2.5%)，组间比较差异有统计学意义(P 　　【Key words】 输尿管结石；坦索罗辛；山莨菪碱 　　 　　Comparison of tamsulosin versus 654-2 for the management of lower ureteral stones 　　XIN Yi-jun.Department of urology,Penglai Hospital,China 　　【Abstract】 Objective To compare the efficacy of tamsulosin and anisodimine for the adjunctive expulsive therapy in patients with lower ureteral stones.Methods A total of 120 patients with stones(0.4-0.8 cm in diameter)located in the lower ureter(juxtavesical or intramural tract)were randomly divided into 3 groups(40 cases in each group).Group 1 served as controls; group 2 received anisodimine(10 mg,3 times daily); and group 3 received tamsulosin(0.4 mg,once daily).All patients were observed for 2 weeks.Results During 2 weeks,expulsion of stones was observed in 17 cases(42.5%)of group 1,in 29(72.5%)of group 2,and 33(82.5%)of group 3.The difference in expulsion rates between groups 2,3 and group 1 was statistically significant(P0.05).In groups 1,2 and 3,renal colic recurred within 2 weeks and analgesics were used in 12 cases(30%),5(12.5%)and 1(2.5%),respectively,with significant difference between the groups(P2.5 cm)、严重发热、多发性肾结石、肾功能衰竭、妊娠期和哺乳期患者。120例随机分3组，每组40例。组1为对照组。男20例，女20例。年龄17~49岁，平均33岁。结石直径6 mm。组2为654-2治疗组。男22例，女18例。年龄18~53岁，平均34岁。结石直径7 mm。组3为坦索罗辛治疗组。男21例，女19例。年龄21~55岁，平均38岁。结石直径7?。3组患者的平均年龄、性别比例、结石大小比较差异均无统计学意义(P0.05)。 　　1.2 治疗方法 治疗期间3组患者均口服左氧氟沙星0.2 g，2次/d；肾石通颗粒4 g,2次/d；每??治疗观察不超过2周。对照组未给予输尿管平滑肌松弛剂。组2患者给予654-2 10 mg，3次/d,口服2周。所有患者在治疗期间每天均需饮水约2 L。患者均随访至2周，每周复查1次，包括询问病史、体格检查、B超及X线摄片，检查记录结石是否已排出、排石时间及药物排石治疗的副作用。对2周时结石仍未排出者采取体外冲击波碎石术(ESWL)或经输尿管镜治疗。 　　1.3 统计学方法 应用SPSS 11.0软件对三组数据进行分析。计数资料采用百分比表示，采用秩和检验，计量资料采用均数±标准差(x±s）表示，采用方差分析。以P0.05)，排出结石平均大小与残留结石平均大小比较差异