特拉唑嗪联合塞来昔布在输尿管镜碎石术后的应用

目的探讨单纯输尿管中下段结石患者在输尿管镜下U100双频双脉冲激光碎石术后,联合使用特拉唑嗪和塞来昔布治疗的临床疗效。方法选取输尿管中下段结石患者59例,均接受输尿管镜下U100激光碎石术,2例术中发生明显输尿管穿孔者予以剔除,对照组32例常规留置双J管2~4周;药物组25例不留置双J管,术后6h起予口服特拉唑嗪片1次2mg,1日1次,塞来昔布胶囊1次0.2g,1日2次,药物口服2周。记录术后2周内相应的并发症并了解结石排出情况。结果药物组并发症的总发生率包括腰腹胀痛、尿频尿急、血尿等明显小于对照组（P〈0.05）。结石清除率100%与对照组的结石清除率一致。结论对单纯性输尿管中下段结石输尿管镜碎石术的患者可不放置双J管,联合使用特拉唑嗪和塞来昔布治疗的效果良好,并发症少。

Efficacy of expulsive therapy using terazosin and celecoxib after ureteroscopic lithotripsy of ureteral stones

OBJECTIVES Our study aimed at defining the role of terazosin and celecoxib as adjunctive therapy after ureteroscopic lithotripsy of middle-or low-portion ureteral stones with U100 double frequency and double pulse laser.METHODS A randomized clinical trial prospectively was performed on 59 patients with ureteral stones,all were managed with U100 double frequency and double pulse laser.Two patients were dropped out due to ureteral wall rupture.After ureteroscopic lithotripsy,all patients were randomLy assigned to two groups.Group one(32 cases) had double J ureteral cathers indwelled,group 2(25 cases) had no cathers indwelled.In group 2 terazosin and celecoxib was started 6 hours after ureteroscopic lithotripsy,the medical therapy is celecoxib 0.2 twice daily and terazosin 0.2mg once at night,the medical therapy continued 2 weeks.The complications and stone-free rates were recorded duringthis time.RESULTS All patients in both group became stone free.There is statistically significant differences in the incidences of flank pain,urine frequeny,dysuria,hematuri etc.between two groups(P<0.05).CONCLUSION This study suggested that there is no need in placing double J catheter after ureteroscopic lithotripsy which is without complications.A combination of terazosin and celecoxib after ureteroscopic lithotripsy has a good effect and few complications.