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[辅助药物治疗对体外冲击波碎石术后远端输尿管结石早期排出的影响]

[Effect of adjunctive drug therapy on early expulsion of distal ureteral calculi after extracorporeal shock wave lithotripsy].

作者信息

Ji M H, Zhang X, Han X, Wang X, Cui L

机构信息

Deparment of Urology Surgery, Civil Aviation General Hospital, Beijing 100123, China.

Department of Dermatology, Beijing Ningshe Medical Beauty Clinic, Beijing 100027, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2023 Mar 28;103(12):924-926. doi: 10.3760/cma.j.cn112137-20221201-02545.

Abstract

To evaluate the efficacy of ketochromate tromethamine and phloroglucinol combination therapy in early expulsion of ureteral calculi after extracorporeal shockwave lithotripsy (ESWL) in patients with distal ureteral clculi. The clinical and follow-up data of 275 patients with lower ureteral calculi who underwent ESWL were collected retrospectively in Civil Aviation General Hospital from January 1 2021 to June 30 2021. According to whether adjunctive medication used before ESWL patients were divided into control group and medication group (with ketochromate tromethamine 30 mg and phloroglucinol 80 mg before ESWL). Primary endpoint is the clearance rate of ureteral calculi after ESWL, secondary endpoint are the other outcomes and drug allergy. There were 138 cases in control group [117 were males and mean age (42±13) years]. Meanwhile, there were 137 cases in medication group [118 were males and mean age (42±12) years]. The clearance rate of ureteral calculi at 24 h (67.88% vs 48.55%, 0.001)、one week (76.64% vs 57.97%, 0.001) and four weeks (89.05% vs 76.08%, =0.005)after ESWL in medication group were significant higher than that in control group. There was a significant difference in the VAS score of pain scale after ESWL (1.77±0.80 vs 2.06±1.04, 0.012) and re-ESWL rate (8.03% vs 17.39%,=0.02) between two groups, but no difference with gross hematuria in 6 h after ESWL and drug allergy. Conclusions combination use of ketochromate tromethamine and phloroglucinol significantly improve early expulsion of ureteral calculi after ESWL in patients with distal ureteral calculi, with no side effect.

摘要

评估氨丁三醇酮咯酸和间苯三酚联合治疗对输尿管下段结石患者体外冲击波碎石术(ESWL)后输尿管结石早期排出的疗效。回顾性收集2021年1月1日至2021年6月30日在民航总医院接受ESWL治疗的275例输尿管下段结石患者的临床和随访资料。根据ESWL前是否使用辅助药物,将患者分为对照组和药物组(ESWL前使用氨丁三醇酮咯酸30mg和间苯三酚80mg)。主要终点是ESWL后输尿管结石的清除率,次要终点是其他结局和药物过敏情况。对照组有138例[男性117例,平均年龄(42±13)岁]。同时,药物组有137例[男性118例,平均年龄(42±12)岁]。药物组ESWL后24小时(67.88%对48.55%,P=0.001)﹑1周(76.64%对57.97%,P=0.001)和4周(89.05%对76.08%,P=0.005)输尿管结石清除率显著高于对照组。两组ESWL后疼痛量表的视觉模拟评分(VAS)(1.77±0.80对2.06±1.04,P=0.012)和再次ESWL率(8.03%对17.39%,P=0.02)有显著差异,但ESWL后6小时肉眼血尿和药物过敏情况无差异。结论氨丁三醇酮咯酸和间苯三酚联合使用可显著提高输尿管下段结石患者ESWL后输尿管结石的早期排出率,且无副作用。

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