Mohseni Mohammad G, Hosseini Seyed R, Alizadeh Farshid
Department of Urology, Urology Ward, Tehran University of Medical Sciences, Sina Hospital, Hassan Abad Square, PO Box 11367-46911, Tehran, Iran.
Saudi Med J. 2006 Jun;27(6):838-40.
To determine the efficacy of terazosin as a facilitator agent for the passage of lower ureteral stones.
Since February 2004 to December 2004, 64 patients with lower ureteral stones who came to the emergency department were enrolled in this study. Exclusion criteria were the presence of urinary tract infection, severe hydronephrosis, elevated serum creatinine, hypertension, history of peptic ulcer disease and history of spontaneous stone passage. Patients were randomized into 2 groups of 32. Group 1 patients received terazosin tablets, 10 mg daily and analgesic (indomethacin capsules) for a maximum of 4 weeks, but patients in Group 2 received only analgesic. In cases of incomplete pain control, intravenous pethidine was administered. The 2 groups were compared with regard to stone passage rate, time to stone passage, the amount of received pethidine and the need for intervention. Statistical analysis was performed by student t-test.
The mean age of Group 1 was 44 years and Group 2 was 39 years. The median stone size was 6.9 +/- 2.3 mm in Group 1 and 6.6 +/- 3.1 mm in Group 2, which was not significantly different. Stone expulsion rate was 90.62% in Group 1 and 62.5% in Group 2, with a significant statistical difference (p=0.041). The mean expulsion time was 76.3 +/- 60 hours and 141 +/- 64 hours in Groups 1 and 2, (p=0.001). Extra analgesic (pethidine) requirement averaged 34.4 +/- 12.7 mg and 62.1 +/- 10.5 mg in Groups 1 and 2 (p=0.036). Seven patients in Group 1 and 15 patients in Group 2 required ureteroscopy after 4 weeks due to lack of the stone passage.
Terazosin is a safe and effective treatment for lower ureteral stones. By using this medication, stone passage rate increases and the time of stone passage and the need for intervention decreases.
确定特拉唑嗪作为促进输尿管下段结石排出药物的疗效。
自2004年2月至2004年12月，64例因输尿管下段结石前来急诊科就诊的患者纳入本研究。排除标准包括存在尿路感染、严重肾积水、血清肌酐升高、高血压、消化性溃疡病史及自发排石史。患者被随机分为两组，每组32例。第1组患者服用特拉唑嗪片，每日10 mg，并服用镇痛药（吲哚美辛胶囊），最长4周，但第2组患者仅服用镇痛药。若疼痛控制不完全，则给予静脉注射哌替啶。比较两组的结石排出率、排石时间、哌替啶用量及干预需求。采用学生t检验进行统计学分析。
第1组的平均年龄为44岁，第2组为39岁。第1组结石中位大小为6.9±2.3 mm，第2组为6.6±3.1 mm，差异无统计学意义。第1组结石排出率为90.62%，第2组为62.5%，差异有统计学意义（p = 0.041）。第1组和第2组的平均排石时间分别为76.3±60小时和141±64小时（p = 0.001）。第1组和第2组额外镇痛药（哌替啶）的平均需求量分别为34.4±12.7 mg和62.1±10.5 mg（p = 0.036）。4周后，第1组有7例患者、第2组有15例患者因结石未排出需要进行输尿管镜检查。
特拉唑嗪是治疗输尿管下段结石的一种安全有效的药物。使用该药物可提高结石排出率，缩短排石时间，并减少干预需求。
