山莨菪碱注射液对输尿管结石绞痛发作的临床研究

发布时间：2018-06-14 22:35

本文选题：输尿管结石 + 绞痛　；参考：《中国临床药理学杂志》2017年14期

【摘要】：目的观察山莨菪碱联合吲哚美辛栓或哌替啶或曲马多缓解输尿管结石绞痛发作的临床疗效与安全性。方法将150例输尿管结石绞痛发作患者随机分为A组55例和B组53例,C组42例。A组给予山莨菪碱10 mg,每日1~2次,静脉注射,同时联合吲哚美辛栓100 mg,塞肛,每日1次;B组给予山莨菪碱10 mg,每日1~2次,静脉注射,同时给予哌替啶75 mg,每日1次,静脉注射;C组给予山莨菪碱10 mg,每日1~2次,静脉注射,同时给予曲马多100 mg,每日1次,肌内注射;在急诊观察室留观1~3 d,结石排出或疼痛缓解者结束观察;结石较大(直径大于8~10 mm)者转泌尿外科进行碎石或输尿管镜下取石治疗。比较3组药物镇痛有效率、复发率、起效时间、持续时间和药物不良反应发生情况。结果 A、B、C组镇痛有效率分别为90.90%(50/55例),73.58%(39/53例),71.43%(30/42例)。A组30 min内起效42例(76.36%),B组27例(50.94%),C组22例(52.38%),A组镇痛有效率、复发率和30 min内起效例数与B、C组比较,差异均有统计学意义(均P0.05)。A、B、C组药物平均维持时间分别为(28.27±0.20),(25.75±0.23),(25.74±0.24)h,A组与B、C组相比差异有统计学意义(P0.01)。3组的药物不良反应主要表现为面红、视物模糊、口干、排尿困难、腹胀、头晕、呕吐、恶心、成瘾。A组药物不良反应发生率为5.45%(3/55例);B、C组分别为28.30%(15/53例),26.19%(11/42例),与A组比较,差异有统计学意义(P0.01)。结论山莨菪碱联合吲哚美辛栓塞肛缓解输尿管结石引发的绞痛的临床疗效确切,药物不良反应发生率低。
[Abstract]:Objective to observe the efficacy and safety of anisodamine combined with indomethacin suppository or pethidine or tramadol in the treatment of ureteral calculi and colic. Methods 150 patients with colic attack of ureteral calculi were randomly divided into group A (55 cases) and group B (53 cases). Group A (42 cases) were given anisodamine 10 mg, twice a day, intravenous injection, combined with indomethacin suppository 100 mg, anal plug. Group B was given 10 mg anisodamine once a day, twice a day once a day, and pethidine 75 mg once a day. Group C was given anisodamine 10 mg once a day, twice a day, and tramadol 100 mg, once a day. Intramuscular injection; in the emergency observation room for 1 to 3 days, the stone excretion or pain relief was completed; the larger stone (diameter more than 810 mm) was transferred to urology for lithotripsy or ureteroscopic lithotripsy. The effective rate, recurrence rate, onset time, duration and adverse drug reaction of the three groups were compared. Results the effective rates of analgesia in group A were 90.90 / 50 / 55 and 73.58 / 39 / 53, respectively. In group A, 42 cases were effective within 30 min of 71.43% and 42 cases in group A were effective within 30 min. In group B, there were 27 cases in group B (n = 27) and 22 cases in group C (n = 22). The recurrence rate and the number of cases in 30 min were compared with those in group B (n = 20). There were significant differences between the two groups (the average maintenance time of the drug in group C was 28.27 卤0.20, respectively, 25.75 卤0.23, 25.74 卤0.24). There were significant differences in adverse drug reactions between group A and group B (P 0.01), such as red face, blurred vision, dry mouth, dizziness, dizziness and dizziness. The incidence of adverse drug reactions in group A of vomiting, nausea and addiction was 5.45 / 3 / 55 / 55 cases respectively, and that in group C was 28.30 / 15 / 53 (26.19 / 11 / 42), which was significantly higher than that in group A (P 0.01). Conclusion Anisodamine combined with indomethacin is effective in the treatment of colic caused by ureteral calculi, and the incidence of adverse drug reactions is low.
【作者单位】：绍兴第二医院急诊科;
【基金】：浙江省医药卫生科技计划基金资助项目(2011D10018)
【分类号】：R693.4

【参考文献】