盐酸坦索罗辛联合糖皮质激素治疗输尿管下段结石的临床研究

目的评价盐酸坦索罗辛联合糖皮质激素治疗输尿管下段结石的临床效果。方法采用随机数字表法将患者分为A、B两组，每组65例。A组（对照组）：采用黄体酮20mg，肌肉注射，2次／d，金钱草冲剂10g/次，3次／电疼痛难忍时给予盐酸曲马多注射液100mg或哌替啶50mg，肌肉注射；B组（试验组）：除A组上述治疗外，加用盐酸坦索罗辛0．4mg／次，每晚饭后1次，以及醋酸泼尼松片10mg／次，1次／d。两组治疗期间多饮水（每日饮水2500-3000ml）、多运动。每位患者疗程为6周，每周复查B超或腹部平片，记录结石位置、排石情况、是否有肾积水、是否有肾绞痛、有无药物副作用等。结石排出即治疗结束，6周后结石仍未排出者，改行输尿管镜下气压弹道碎石术或取石术。结果治疗组完全排石率达81％，对照组完全排石率为64％，两组结果差异有统计学意义。治疗组与对照组结石排出时间分别为（6．8±2．5）d和（10．5±3．4）d，差异有统计学意义。结论盐酸坦索罗辛与糖皮质激素联用治疗输尿管下段结石能有效提高排石率，缩短排石时间，降低手术治疗率。

Clinical research of tamsulosin combined with glucocorticoid in the treatment of lower ureteral stones

Objective To evaluate the efficacy of Tamsulosin combined with glucocorticoid in treatment of lower ureteral stones. Methods According to the form law of random digit, 130 cases of distal uretal stones were randomly divided into treatment group and control group. The patients in control group were assigned to receive progestin 20 mg im 2 times/day, money grass granule 10 g, 3 times/day,when feel painful using hydrochloric acid tramadol injection 100 mg or Pethidine 50 mg im; In treatment group, the tamsulosin was administrated as 0. 4 mg per day and prednisone was administrated as 10 mg per day for the treatment regime, with all patients drinking 2500 - 3000 ml one day. Observation lasted 6 weeks and also stone expelled as end point. To give a surgical treatment if the stone did not expelled after 4 weeks. Results 81% cases in the treatment group got ureteral stone eliminated during observation period, while 64% in control group, with significant difference（ P 〈 0. 05 ）. The time that stone expelled were （6. 8 ± 2. 5 ） d in treatment group and （ 10. 5 ± 3.4 ） d in control group respectively, with significant difference（ P 〈 0. 05 ）. Conclusion Tamsulosin combined with glueocortieoid could be used in the treatment of distal ureter stone and could help the stones clearance, with the time of the stone eduction shorten and surgical probability reduced.