Wang Hui-jun, Liu Ke, Ji Zhi-gang, Li Han-zhong
Department of Urology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2008 Aug;30(4):506-8.
To evaluate the efficacy of alpha1-adrenergic antagonist in the medical management of lower ureteral stone with extracorporeal shock wave lithotripsy (ESWL).
A total of 80 patients with stone located in lower ureter were randomly divided into two groups. Group 1 served as control and group 2 received tamsulosin (0.4 mg, once daily) after ESWL. All patients were observed for 2 weeks and asked to compile a diary about renal colic, stone expulsion, use of analgesic drugs, and side effects of medical therapy.
During 2 weeks, stones were expulsed in 18 patients (45.0%) of group 1 and in 31 patients (77.5%) of group 2. The expulsion rate between group 1 and group 2 was significantly different (P < 0.01). Eight patients (20.0%) in group 1 and 2 patients (5.0%) in group 2 experienced renal colic relapse within 2 weeks and were administered with analgesics (P < 0.05). No side effect in group 1 was reported, except that 2 patients in group 2 complained of slight dizziness.
Tamsulosin (alpha1-adrenergic antagonist) can improve the stone-free rate of lower ureteral stones after ESWL and reduce the relapse of renal colic. As a safe and effective agent, it can be regarded as an auxiliary clearance method after ESWL for lower ureteral stones.
评估α1肾上腺素能拮抗剂在体外冲击波碎石术(ESWL)治疗输尿管下段结石中的疗效。
将80例输尿管下段结石患者随机分为两组。第1组作为对照组,第2组在ESWL术后服用坦索罗辛(0.4毫克,每日1次)。观察所有患者2周,并要求他们记录肾绞痛、结石排出情况、镇痛药使用情况及药物治疗的副作用。
在2周内,第1组有18例患者(45.0%)结石排出,第2组有31例患者(77.5%)结石排出。第1组和第2组的结石排出率有显著差异(P < 0.01)。第1组有8例患者(20.0%)在2周内出现肾绞痛复发并接受了镇痛治疗,第2组有2例患者(5.0%)出现这种情况(P < 0.05)。第1组未报告副作用,第2组有2例患者抱怨有轻微头晕。
坦索罗辛(α1肾上腺素能拮抗剂)可提高ESWL术后输尿管下段结石的结石清除率,并减少肾绞痛复发。作为一种安全有效的药物,它可被视为ESWL术后输尿管下段结石的辅助清除方法。