【摘要】 目的探讨甲基泼尼松龙、坦索罗辛在微创手术治疗输尿管结石中的辅助作用。方法前瞻性研究选取自2013年6月至2015年6月住院治疗164例X线阳性输尿管结石患者作为研究对象,按照简单随机法将患者分为三组。三组患者行体外超声波治疗后,A组40例患者行中成药尿石通治疗,B组62例患者行中成药尿石通联合坦索罗辛治疗,C组62例患者行中成药尿石通联合、坦索罗辛联合甲基泼尼松治疗。比较三组患者治疗效果,尿液中单核细胞趋化蛋白-1(MCP-1)、三叶因子(TFF1)、高迁移率族蛋白(HMGB1)含量变化。结果 C组患者结石排出率、结石排净率明显高于A组、B组(P<0.05);C组结石排出时间明显低于A组、B组(P<0.05);C组石街形成率明显低于A组、B组(P<0.05);C组患者治疗后不良反应发生率明显低于A组、B组(P<0.05)。三组患者治疗后尿液中MCP-1、HMGB1含量较治疗前均有下降(P<0.05);C组患者尿液中MCP-1、HMGB1含量明显低于A组、B组(P<0.05);三组患者治疗前后TFF1含量无明显变化(P>0.05)。A组患者治疗有效率为67.50%,B组患者治疗有效率为79.04%,C组患者治疗有效率为88.71%,C组患者的治疗有效率明显高于A组、B组(P<0.05)。结论输尿管结石患者在体外冲击波碎石治疗结束后,联用坦索罗辛及甲基泼尼松,可提高治疗效果,同时降低患者的不良反应发生风险。更多还原

【Abstract】 Objective To analyze the effect of methylprednisolone and Tamsulosin in the treatment of ureteral calculi with minimally invasive surgery.Methods From June 2013 to June 2015,164 cases of X-ray positive ureteral calculi patients were studied in our hospital.According to the simple random method,they were divided into three groups,three patients in ultrasonic therapy,A group of 40 patients for traditional Chinese medicine Niaoshitong treatment,B group of 62 patients for traditional Chinese medicine Niaoshitong combined tamsulosin treatment,C group were treated with traditional Chinese medicine Niaoshitong combined with tamsulosin combined with methyl prednisone.The effects of treatment and the changes of MCP-1,TFF1 and HMGB1 in urine were compared.Results Stone expulsion rate,the net rate of C group was significantly higher than those of A group and B group(P < 0.05).Stone discharge time of C group was significantly lower than those of A group and B group(P < 0.05);stone of C group was obviously lower than those of A group and B group(P < 0.05).Adverse reactions of C group after treatment was significantly lower than those of A group and B group(P < 0.05).MCP-1 in urine and HMGB1 content after treatment were decreased compared with before treatment(P < 0.05).MCP-1,the content of HMGB1 in urine of C group were significantly lower than those of A group and B group(P < 0.05).TFF1 before and after treatment showed no significant change(P > 0.05).The effective rate of A group was67.50%,the effective rate of B group was 79.04%,the effective rate of C group was 88.71%,and the effective rate of C group was significantly higher than that of group A and group B(P < 0.05).Conclusion Extracorporeal shock wave lithotripsy,combined with tamsulosin and methyl prednisone,can improve the treatment effect,and reduce the incidence of adverse reactions in patients with ureteral calculi.更多还原