坦索罗辛和托特罗定对输尿管下段结石排石作用的比较

目的 分析比较坦索罗辛和托特罗定在输尿管下段结石辅助排石中的疗效.方法 将160例输尿管下段结石患者按区组随机化方法 分成四组,每组各40例.结石直径4～10 mm.Ⅰ组给予坦索罗辛0.4 mg,1次/d.Ⅱ组给予坦索罗辛0.4mg,1次/d,加托特罗定2 mg,2次/d.Ⅲ组给予托特罗定2 mg,2次/d.Ⅳ组为对照组,未给予输尿管平滑肌松弛剂.每例患者治疗观察期为2周.结果 Ⅰ组排石率为76.9%(30/39),Ⅱ组为70.0%(28/40),Ⅲ组为46.2%(18/39),Ⅳ组为42.1%(16/38),Ⅰ、Ⅱ组的排石率明显高于Ⅲ、Ⅳ组,差异有统计学意义(p＜0.05),Ⅰ、Ⅱ组之间,Ⅲ、Ⅳ组之间差异无统计学意义(P＞0.05).排石时间Ⅰ～Ⅳ组分别为(5.3±2.5)、(6.4±2.2)、(10.7±1.8)、(12.8±3.4)d,Ⅰ、Ⅱ组分别与Ⅲ、Ⅳ组之间,Ⅲ、Ⅳ组之间比较差异均有统计学意义(P＜0.05),Ⅰ、Ⅱ组之间比较差异无统计学意义(P＞0.05).4例因不能耐受而退出研究.2周内四组均未出现明显不良反应.结论 坦索罗辛在治疗输尿管下段结石方面安全、有效,能明显提高排石率;而托特罗定则可以缩短排石时间,但和坦索罗辛合用并无额外的优势.

Comparative evaluation of efficacy of tamsulosin versus tolterodine for the management of lower ureteral stones

Objective To compare the efficacy of tamsulosin and tolterodine for the adjunctive expulsive therapy in patients with lower ureteral stones.Methods A total of 160 patients with lower ureteral stones(4-10 mm)were included in the study.The patients were divided into 4 groups by block randomization.Group Ⅰ patients received tamsulosin 0.4 mg/d;group Ⅱpatients received tamsulosin 0.4 mg/d plus tolterodine 2 mg(twice a day);group Ⅲ patients received toherodine 2 mg(twice a day);and group Ⅳpatients served as controls.All patients were observed for 2 weeks.Remits The stone expulsion rate of group Ⅰ,Ⅱ,Ⅲ,Ⅳ was 76.9%(30/39),70.0%(28/40),46.2%(18/39)and 42.1%(16/38),respectively.The stone expulsion rate in group ⅠandⅡwas,higher than that in group Ⅲand Ⅳ(P＜0.05).The expulsion time of group Ⅰ,Ⅱ,Ⅲ,Ⅳ was(5.3±2.5),(6.4±2.2),(10.7±1.8),(12.8±3.4)d,respectively,with significant differences between group Ⅰ,Ⅱ andⅢ,Ⅳ,between groupⅢand Ⅳ(P＜0.05).Almost all of the patients tolerated the expulsive therapy and only 4 patients withdrew from treatment.No obvious side effect occurred.Conclusion The use of tamsulosin for the expulsion of lower ureteral stones is effective and safe;however,the use of tolteredine provides no additional advantages.