阿呋唑嗪和坦索罗辛治疗输尿管结石的临床疗效对比

发布时间：2018-04-15 01:34

  本文选题：输尿管结石 + α受体阻滞剂　； 参考：《新疆医科大学》2014年硕士论文

【摘要】：目的:应用α受体阻滞剂坦索罗辛和阿呋唑嗪治疗输尿管结石，进行前瞻性随机对照研究，对坦索罗辛和阿呋唑嗪治疗输尿管结石的临床疗效对比，从而为临床合理用药提供依据。方法:选取2013年10月—2014年6月，我院泌尿外科门诊临床表现、体征、相关实验室检查及影像学检查确证为输尿管结石的患者304例患者入组，根据随机数字表法随机分为A试验组（阿呋唑嗪）和B对照组（坦索罗辛）。所有患者在治疗期间保持每日尿量2000ml～3000ml。详细记录每例患者的结石位置，大小等，每位患者临床检查结石排出，或者经过临床医生会诊需要改为手术治疗的为记录和研究结束点。肾绞痛的患者应用数字疼痛评分法（NRS），以观察脸部表情及询问主观感受的方法来综合评价患者疼痛的症状。结果:试验组患者为160例,男性131例,女性29例,年龄21岁~61岁,平均年龄37.33±10.12岁；对照组患者为160例,男性120例,女性40例,年龄19岁~60岁,平均年龄37.44±11.12岁。试验组和对照组均能促进结石排出，对照组在结石排出率和排出时间方面较试验组有显著性差异（P＜0.05），试验组与对照组总疗效有显著性差异（P＜0.05）；试验组和对照组对输尿管上段和中段结石的排出率与排石时间没有显著性差异（P0.05），对下段结石排出率和排出时间有显著性差异（P＜0.05）；试验组和对照组对≤5mm结石的排出率没有显著性差异（P0.05），而对排出时间有显著性差异（P＜0.05）；对≥5mm结石的排出率及排出时间均有有显著性差异（P＜0.05），试验组和对照组对肾绞痛缓解率有显著性差异（P＜0.05）。试验组和对照组不良反应没有显著性差异（P0.05）。对照组优于试验组药物的成本-效果。结论:1.坦索罗辛和阿呋唑嗪均能促进输尿管结石的排出，缩短结石排出的时间。2.坦索罗辛和阿呋唑嗪对输尿管上段和中段的结石排出率及排出时间两药无明显差异，对输尿管下段结石，坦索罗辛优于阿呋唑嗪。总的排石疗效比较，坦索罗辛优于阿呋唑嗪。3.对于小于或等于5mm的输尿管结石，坦索罗辛和阿呋唑嗪均能促进结石的排出，，缩短结石排出时间，但坦索罗辛较阿呋唑嗪能明显的缩短结石排出时间；对于大于或等于5mm的输尿管结石，坦索罗辛排石的效果优于阿呋唑嗪。4.坦索罗辛在缓解肾绞痛方面优于阿呋唑嗪。5.坦索罗辛和阿呋唑嗪对输尿管结石的治疗是安全有效的，无明显的、新发的不良反应,两药的不良反应无明显差异。6.坦索罗辛的成本-效果优于阿呋唑嗪。
[Abstract]:Objective: to treat ureteral calculi with 伪 receptor blocker tamsoloxine and alfuzosin, and to compare the clinical efficacy of tamsoloxine and alfuzosin in the treatment of ureteral calculi.So as to provide the basis for clinical rational use of drugs.Methods: 304 patients with ureteral calculi were selected from October 2013 to June 2014.According to the random number table method, the patients were randomly divided into A group (alfuzosin) and B control group (tamsoloxine).All patients maintained a daily urine volume of 2000ml / 3000ml during treatment.The location, size, etc of each patient's stone were recorded in detail, and each patient's clinical examination of stone excretion, or the clinician consultation needs to be changed to surgical treatment for the end of the record and research point.Patients with renal colic were evaluated with digital pain score (NRSs). The symptoms of pain were evaluated by observing facial expressions and asking subjective feelings.Results: there were 160 patients, 131 males and 29 females, aged 21 years or 61 years, with an average age of 37.33 卤10.12 years in the trial group, and 160 patients, 120 males and 40 females, aged from 19 to 60 years with an average age of 37.44 卤11.12 years in the control group.Both the experimental group and the control group could promote the excretion of stones.There were significant differences in stone excretion rate and time between the control group and the experimental group (P < 0.05), the total curative effect between the test group and the control group was significant (P < 0.05), and the excretion rate of the upper and middle ureteral calculi in the test group and the control group was lower than that in the control group (P < 0.05).There was no significant difference between the two groups (P < 0.05, P < 0.05), but there was no significant difference between the test group and the control group in the excretion rate of 鈮

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