通讯作者: 龙建华, alexseeking2000@163.com

DOI：10.12201/bmr.202603.00119

Effects of Tamsulosin and Silodosin on the Success Rate of Ureteral Access Sheath Insertion and Postoperative Complications

• 摘要：目的 探讨围术期盐酸坦索罗辛和赛洛多辛对输尿管软镜碎石术中一期输尿管通道鞘置入成功率及术后并发症的影响。方法 回顾性选取2024年1月至2025年12月于北京市垂杨柳医院住院行输尿管软镜激光碎石取石术的输尿管上段结石或肾结石患者130例。根据围术期处理措施不同，分为对照组A（n=45例，无特殊干预）、试验组B（n=42例，口服盐酸坦索罗辛缓释胶囊0.2mg，qn，7天）、试验组C（n=43例，口服赛洛多辛胶囊4mg，bid，7天）。比较三组患者的术前资料、手术时间、一期输尿管通道鞘置入成功率以及术后并发症，并进行组间两两比较。结果 三组患者一期手术输尿管通道鞘置入成功率、术后下尿路症状发生率比较差异有统计学意义（P＜0.05）。试验组B（88.1%）、试验组C（90.7%）一期手术输尿管通道鞘置入成功率均高于对照组A（66.7%）（P＜0.05）。试验组B（16.7%）、试验组C（14.0%）术后下尿路症状发生率均低于对照组A（35.6%）（P＜0.05）。三组患者手术时间、术后发热、术后镇痛药物使用、术后血尿情况比较差异无明显统计学意义（P＞0.05）。试验组B、试验组C一期手术输尿管通道鞘置入成功率、术后下尿路症状发生率比较差异无明显统计学意义（P＞0.05）。结论 围术期口服盐酸坦索罗辛或赛洛多辛7天相对于无干预措施均可明显提高输尿管软镜碎石术中一期输尿管通道鞘置入成功率，并可降低术后下尿路症状发生率，但对缩短手术时间无明显影响，对术后发热、术后镇痛药物使用、术后血尿情况无明显改善。盐酸坦索罗辛、赛洛多辛对输尿管软镜碎石术中一期输尿管通道鞘置入成功率提高程度无明显差异，对降低术后下尿路症状发生率效果相近。

  关键词： 肾结石; 输尿管结石; 盐酸坦索罗辛; 赛洛多辛; 输尿管软镜碎石术; 输尿管通道鞘

   

  Abstract: Objective To investigate the effects of perioperative tamsulosin and silodosin on the success rate of primary ureteral access sheath insertion and postoperative complications during flexible ureteroscopic lithotripsy. Methods A total of 130 patients with upper ureteral calculi or renal calculi who underwent flexible ureteroscopic laser lithotripsy at Beijing Chuiyangliu Hospital between January 2024 and December 2025 were retrospectively enrolled. According to different perioperative interventions, the patients were divided into control group A (n=45, no special intervention), experimental group B (n=42, oral tamsulosin sustained-release capsules 0.2 mg once daily for 7 days), and experimental group C (n=43, oral silodosin capsules 4 mg twice daily for 7 days). Preoperative baseline data, operation time, success rate of primary ureteral access sheath insertion, and postoperative complications were compared among the three groups, with pairwise comparisons between groups. Results There were significant differences in the success rate of primary ureteral access sheath insertion and the incidence of postoperative lower urinary tract symptoms among the three groups (P<0.05). The success rates of primary ureteral access sheath insertion in group B (88.1%) and group C (90.7%) were significantly higher than that in group A (66.7%) (P<0.05). The incidences of postoperative lower urinary tract symptoms in group B (16.7%) and group C (14.0%) were significantly lower than that in group A (35.6%) (P<0.05). No significant differences were observed in operation time, postoperative fever, postoperative analgesic use, or postoperative hematuria among the three groups (P>0.05). There were no significant differences between group B and group C in the success rate of primary ureteral access sheath insertion or the incidence of postoperative lower urinary tract symptoms (P>0.05). Conclusion Perioperative oral administration of tamsulosin or silodosin for 7 days can significantly improve the success rate of primary ureteral access sheath insertion and reduce the incidence of postoperative lower urinary tract symptoms during flexible ureteroscopic lithotripsy compared with no intervention. However, it shows no significant effect on shortening operation time or improving postoperative fever, analgesic requirement, or hematuria. Tamsulosin and silodosin have similar efficacy in improving the success rate of primary ureteral access sheath insertion and reducing the incidence of postoperative lower urinary tract symptoms, with no significant difference between the two agents.

  Key words: Renal calculi; Ureteral calculi; Tamsulosin; Silodosin; Flexible ureteroscopic lithotripsy; Ureteral access sheath

  提交时间：2026-03-30

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• 序号	提交日期	编号	操作
  1	2026-03-16	10.12201/bmr.202603.00119V1	下载

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