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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P<0.05)。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(P<0.01)。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(P<0.01)。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。
Objective To observe the clinical efficacy and safety of anisodamine combined with indomethacin suppository or pethidine or tramadol in the treatment of ureteral stones with colic. Methods A total of 150 patients with ureteral calculous angina were randomly divided into group A (55 cases), group B (53 cases) and group C (42 cases). Group A was given anisodamine 10 mg once or twice a day by intravenous injection combined with indometacin suppository 100 mg once a day for 1 week. Group B was given anisodamine 10 mg daily for 1 ~ 2 times, intravenous injection, while giving pethidine 75 mg, once daily, intravenous injection; C group given anisodamine 10 mg, 1 or 2 times a day, intravenous injection, while giving tramadol 100 mg, each Day 1, intramuscular injection; observation room in the emergency room to observe 1 ~ 3 d, the stones discharged or pain relief end observation; larger stones (diameter greater than 8 ~ 10 mm) were transferred to Urology gravel or ureteroscopy Stone treatment. The analgesic efficiency, recurrence rate, onset time, duration and adverse drug reactions of the three groups were compared. Results The analgesic efficacies in groups A, B and C were 90.90% (50/55 cases), 73.58% (39/53 cases) and 71.43% (30/42 cases), respectively. In group A, 42 cases (76.36%) were effective in 30 minutes, 27 cases (50.94%) in group B and 22 cases (52.38%) in group C. The effective rate, recurrence rate B, C group, the differences were statistically significant (P <0.05). The average maintenance time of group A, B and C were (28.27 ± 0.20) and (25.75 ± 0.23) and (25.74 ± 0.24) h, respectively. There was significant difference between group A and group B and C (P <0.01) . Adverse drug reactions in the three groups mainly manifested as facial flushing, blurred vision, dry mouth, dysuria, bloating, dizziness, vomiting, nausea, addiction. The incidence of adverse drug reactions in group A was 5.45% (3/55 cases), while in group B and C were 28.30% (15/53 cases) and 26.19% (11/42 cases), respectively, with statistical significance Significance (P <0.01). Conclusion Anisodamine combined with indomethacin embolism anal ureteral calculi relieve angina pectoris clinical efficacy is exact, the incidence of adverse drug reactions is low.