坦索罗辛联合双氯芬酸钠栓治疗下段输尿管结石的随机对照临床研究

目的 评估α1肾上腺能受体阻滞剂联用前列腺素合成酶抑制剂治疗下段输尿管结石的效果.方法 94例下段输尿管结石患者随机为实验组和对照组.实验组予以坦索罗辛0.2 mg 口服,1次/d,双氯芬酸钠栓50 mg肛塞,2次/d;对照组未用药物,等待结石自排.以结石排出输尿管或治疗随访2周为疗效观察终点.结果 实验组和对照组无患者退出研究.实验组排石率[91.5%(43/47)]高于对照组[25.5%(12/47)](P＜0.01);实验组结石排出时间[(6.4±3.7)d]短于对照组[(8.9±4.3)d](P＜0.01);实验组再发肾输尿管绞痛率[4.3%(2/47)]少于对照组[48.9%(23/47)](P＜0.01).结论 坦索罗辛联用双氯芬酸钠栓治疗下段输尿管结石可以缩短结石排出时间,减少并发症,提高排石率.

Efficacy of expulsive therapy using tamsulosin and diclofenac suppository for distal ureteral stones

Objective To evaluate the clinical efficacy of expulsive therapy using alpha 1-selective adrenoblocker and prostaglandin synthetase inhibitor for distal ureteral stones.Methods 94 patients with distal ureteral stone were randomly divided into study group and control group.In study group,47 cases received tamsulosin 0.2mg daily and dielofenac rectal suppositories 50mg 2 times daily,while watchful waiting without tamsulosin and diclofenac suppository in 47 cases of control group.Observation lasted 2 weeks and also stone expelled as end point.Results No severe adverse reactions related to the drugs were noted and no patients withdrew from the study.The stone-free rate was 91.5%(43/47) of the study group and 25.5% (12/47) of the control group (P＜0.01).A mean stone expelling date of the control group was(8.9±4.3)d and that of the study group was(6.4±3.7)d(P＜0.01).Rates of renoureteral colic recurred in the study group and the control group were 4.3%(2/47) and 48.9%(23/47),respectively (P＜0.01).Conclusion Treatment of distal ureteral stones wlth tamsulosin and dielofenac suppository can increase the stone-free rate,shorten mean stone expelling date,decrease rate of renottreteral colic recurred.