评估坦索罗辛在老年输尿管结石患者输尿管镜钬激光碎石术中的术前应用
Evaluation of Preoperative Tamsulosin Use in Ureteroscopic Holmium Laser Lithotripsy for Elderly Patients with Ureteral Stones.
摘要(中文译文)
本方案旨在评估老年输尿管结石患者行输尿管镜钬激光碎石术前短期服用坦索罗辛的围手术期临床结局。回顾性分析年龄≥60岁患者的病历资料，根据术前是否有明确用药记录将患者分为术前坦索罗辛组和对照组。两组基线人口学特征及结石特征具有可比性。对比分析显示，坦索罗辛组手术时间更短、需要输尿管扩张的比例更低、术后炎症反应更轻、住院时间更短，短期随访结石清除率更高。上述差异见于接受术前坦索罗辛治疗的患者与未接受α受体阻滞剂治疗的患者之间的比较。坦索罗辛组术后并发症发生率更低，但部分差异未达到统计学显著性，且未观察到治疗相关的严重不良事件。这些观察结果表明，术前使用坦索罗辛与手术效率改善可能存在关联。该方法或可为适当选择的老年患者提供一种简便的药物策略，以促进输尿管镜入镜及围手术期恢复。然而，由于回顾性设计、单中心环境、样本量有限及随访时间较短，无法确立因果关系及长期安全性。尚需前瞻性多中心随机研究证实上述发现，并进一步明确常规术前使用坦索罗辛在老年患者输尿管镜处理中的作用。
Abstract
The objective of this protocol was to evaluate perioperative clinical outcomes associated with short-course preoperative tamsulosin administration in elderly patients undergoing ureteroscopic holmium:YAG laser lithotripsy for ureteral stones. Medical records of patients aged ≥ 60 years were retrospectively reviewed. Patients were categorized into a preoperative tamsulosin group and a control group based on documented medication exposure prior to surgery. Baseline demographic and stone characteristics were comparable between groups. Comparative analysis showed that operative duration was shorter, the need for ureteral dilation was lower, postoperative inflammatory response was reduced, hospitalization was shorter, and stone-free rates at short-term follow-up were higher in the tamsulosin group. These differences were observed when comparing patients who received preoperative tamsulosin with those who did not receive α-blocker therapy. Postoperative complications occurred less frequently in the tamsulosin group, although several differences did not reach statistical significance, and no treatment-related serious adverse effects were observed. These observations indicate a potential association between preoperative tamsulosin use and improved procedural efficiency. This approach may provide a simple pharmacologic strategy to facilitate ureteroscopic access and perioperative recovery in appropriately selected elderly patients. However, due to the retrospective design, single-center setting, limited sample size, and short follow-up duration, causal relationships and long-term safety cannot be established. Prospective multicenter randomized studies are required to confirm these findings and further define the role of routine preoperative tamsulosin in geriatric ureteroscopic management.
如何引用
AMA
Wenyuan Li, Guojun Wen. Evaluation of Preoperative Tamsulosin Use in Ureteroscopic Holmium Laser Lithotripsy for Elderly Patients with Ureteral Stones.. Journal of visualized experiments : JoVE. 2026; doi:10.3791/69898.
APA
Wenyuan Li, Guojun Wen (2026). Evaluation of Preoperative Tamsulosin Use in Ureteroscopic Holmium Laser Lithotripsy for Elderly Patients with Ureteral Stones.. Journal of visualized experiments : JoVE. https://doi.org/10.3791/69898
GB/T 7714
Wenyuan Li, Guojun Wen. Evaluation of Preoperative Tamsulosin Use in Ureteroscopic Holmium Laser Lithotripsy for Elderly Patients with Ureteral Stones.[J]. Journal of visualized experiments : JoVE, 2026 doi:10.3791/69898.
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