目的 探讨坦索罗辛在输尿管下段结石ESWL后辅助排石中的效果.方法 较大输尿管下段结石(直径>10mm)80例患者随机分成两组,I组为对照组(B组),ESWL后应用吲哚美辛25mg,3次/d,排石颗粒5g,3次/d;Ⅱ组为坦索罗辛治疗组(A组),ESWL后在对照组治疗方案基础上予以口服坦索罗辛0.4mg,1次/d.每例患者观察时间不超过2周.结果 在观察时间内两组排石率分别为47.5%和82.5%,两组比较差异有统计学意义(P<0.01).观察时间内两组再次发生肾绞痛而需镇痛药治疗的患者分别为15.0%和7.5%,两组比较差异有统计学意义(P<0.01).治疗组除1例发生头晕外,无其他不良反应发生.结论 坦索罗辛能提高输尿管下段较大结石ESWL后的排石率,减少再发生肾绞痛的概率,且安全有效.可作为输尿管下段较大结石ESWL后的辅助排石方法.%Objective To investigate the efficacy of tamsulosin in the medical management of large lower ureteral stone with ESWL. Methods A total of 84 patients with large stone (diameter ＞ 10mm) located lower ureter were randomly divided into 2 groups, Group Ⅰ served as controls; group Ⅱ received tamsulosin( 0. 4mg, once daily)after ESWL. All patients were observed for 2 weeks. Results During 2 weeks, expulsion rate of stone was 47.5％ (19/40) in group Ⅰ, and 82.5％ (33/40) of group Ⅱ. The difference in expulsion rates between group Ⅰ and group Ⅱ was statisticallysignificant(P ＜ 0. 01 ). In group Ⅰ and group Ⅱ, renal colic recurred within 2 weeks and analgesics were used in 6 cases ( 15.0％ ) and in 3 cases (7.5％) with statistically significant (P ＜0.01 ). Conclusions Tamsulosin is safe and effective for adjunctive expulsive treatment for large lower ureteral stone with ESWL.It can significantly improve the stone expulsion rate.
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