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阿夫唑嗪在冲击波碎石术后治疗输尿管结石的疗效。

Efficacy of alfuzosin after shock wave lithotripsy for the treatment of ureteral calculi.

作者信息

Cho Hee Ju, Shin Soon Cheol, Seo Do Young, Min Dong Suk, Cho Jeong Man, Kang Jung Yoon, Yoo Tag Keun

机构信息

Department of Urology, Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.

出版信息

Korean J Urol. 2013 Feb;54(2):106-10. doi: 10.4111/kju.2013.54.2.106. Epub 2013 Feb 18.

Abstract

PURPOSE

We evaluated the efficacy of alfuzosin for the treatment of ureteral calculi less than 10 mm in diameter after extracorporeal shock wave lithotripsy (ESWL).

MATERIALS AND METHODS

A randomized, single-blind clinical trial was performed prospectively by one physician between June 2010 and August 2011. A total of 84 patients with ureteral calculi 5 to 10 mm in diameter were divided into two groups. Alfuzosin 10 mg (once daily) and loxoprofen sodium 68.1 mg (as needed) were prescribed to group 1 (n=41), and loxoprofen sodium 68.1 mg (as needed) only was prescribed to group 2 (n=44). The drug administration began immediately after ESWL and continued until stone expulsion was confirmed up to a maximum of 42 days after the procedure.

RESULTS

Thirty-nine of 41 (95.1%) patients in group 1 and 40 of 43 (93.0%) patients in group 2 ultimately passed stones (p=0.96). The number of ESWL sessions was 1.34±0.65 and 1.41±0.85 in groups 1 and 2, respectively (p=0.33). The patients who required analgesics after ESWL were 8 (19.5%) in group 1 and 13 (30.2%) in group 2 (p=0.31). Visual analogue scale pain severity scores were 5.33±1.22 and 6.43±1.36 in groups 1 and 2, respectively (p=0.056). The time to stone expulsion in groups 1 and 2 was 9.5±4.8 days and 14.7±9.8 days, respectively (p=0.005). No significant adverse effects occurred.

CONCLUSIONS

The use of alfuzosin in combination with ESWL seems to facilitate stone passage and to reduce the time of stone expulsion but does not affect the stone-free rate.

摘要

目的

我们评估了阿夫唑嗪在体外冲击波碎石术(ESWL)后治疗直径小于10mm输尿管结石的疗效。

材料与方法

2010年6月至2011年8月,由一名医生前瞻性地进行了一项随机、单盲临床试验。总共84例直径5至10mm的输尿管结石患者被分为两组。第一组(n = 41)患者服用阿夫唑嗪10mg(每日一次)和洛索洛芬钠68.1mg(必要时服用),第二组(n = 44)患者仅服用洛索洛芬钠68.1mg(必要时服用)。药物在ESWL后立即开始服用,并持续至结石排出得到确认,最长持续至术后42天。

结果

第一组41例患者中有39例(95.1%)最终排出结石,第二组43例患者中有40例(93.0%)最终排出结石(p = 0.96)。第一组和第二组的ESWL治疗次数分别为1.34±0.65次和1.41±0.85次(p = 0.33)。ESWL后需要镇痛的患者在第一组有8例(19.5%),在第二组有13例(30.2%)(p = 0.31)。第一组和第二组的视觉模拟评分法疼痛严重程度评分分别为5.33±1.22和6.43±1.36(p = 0.056)。第一组和第二组的结石排出时间分别为9.5±4.8天和14.7±9.8天(p = 0.005)。未发生明显不良反应。

结论

阿夫唑嗪联合ESWL使用似乎有助于结石排出并缩短结石排出时间,但不影响结石清除率。

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