Ahmad Hussain, Azim Waqar, Akmal Muhammad, Murtaza Badar, Mahmood Arshad, Nadim Amir, Shahzad Khubaib
J Ayub Med Coll Abbottabad. 2015 Jan-Mar;27(1):48-50.
Many minimally invasive interventional techniques as well as expectant treatment exist for the management of lower ureteric calculi. This study was conducted to evaluate th efficacy of tamsulosin as an expulsive pharmacologic therapy for the treatment of distal uretern stone.
This randomized control trial included 100 patients over 18 years of age wit stone Size > or = mm in distal 1/3 of ureter. Patients were randomly assigned into two groups (A & B Group A Patients were given Capsule Tamsulosin 0.4 mg, 1 daily up to 4 weeks while group B patients were given placebo, 1 Capsule daily up to 4 weeks. The primary endpoint was expulsio rate. A written informed consent was taken from all the patients. Expulsion time, need for analgesics, need for hospitalization and drug side effects were secondary endpoints.
A total of 49 patients in group A and 48 patients in group B reported back, therefore 97 out of 10 patients were evaluated. Mean age of the patients was 36.34 years (range 18-57 years). Mea stone size was 5.78 mm (range 4-8 mm) in greatest dimension. A stone expulsion rate of 85.71C (42 patients) was noted in group A and 54.20% (26 patients) in group B. Group A revealed statistically significant advantage in term of stone expulsion rate (p=0.032). Considering expulsio time in days group A showed statistically significant advantage (p=0.015). Regarding age, se) stone size and stone lateralization (right/left), there was no significant difference between th group A and B. No drug side effects were noted in both the groups.
By usin tamsulosin a higher stone expulsion rates can be achieved in a shorter time. More randomize control trials are required to establish tamsulosin as a standard medical expulsive treatment fc
对于下段输尿管结石的治疗，存在多种微创介入技术以及保守治疗方法。本研究旨在评估坦索罗辛作为一种排石药物疗法治疗远端输尿管结石的疗效。
本随机对照试验纳入了100例年龄超过18岁、输尿管远端1/3处结石大小≥4mm的患者。患者被随机分为两组（A组和B组）。A组患者服用0.4mg坦索罗辛胶囊，每日1次，共4周；而B组患者服用安慰剂，每日1粒，共4周。主要终点是排石率。所有患者均签署了书面知情同意书。排石时间、镇痛需求、住院需求和药物副作用为次要终点。
A组共有49例患者、B组共有48例患者回访，因此对100例患者中的97例进行了评估。患者的平均年龄为36.34岁（范围18 - 57岁）。结石最大直径的平均大小为5.78mm（范围4 - 8mm）。A组的结石排石率为85.71%（42例患者），B组为54.20%（26例患者）。A组在结石排石率方面显示出统计学上的显著优势（p = 0.032）。从排石天数来看，A组显示出统计学上的显著优势（p = 0.015）。在年龄、结石大小和结石位置（右侧/左侧）方面，A组和B组之间没有显著差异。两组均未观察到药物副作用。
使用坦索罗辛可在更短时间内实现更高的结石排石率。需要更多的随机对照试验来将坦索罗辛确立为治疗远端输尿管结石的标准药物排石疗法。
