山莨菪碱注射液对输尿管结石绞痛发作的临床研究  

Clinical trial of anisodamine injectionin the treatment of ureteral calculus colic

作　　者：张卫娟[1] 陈洁[1] 

机构地区：[1]绍兴第二医院急诊科,浙江绍兴312000

出　　处：《中国临床药理学杂志》2017年第14期1363-1365,共3页The Chinese Journal of Clinical Pharmacology

基　　金：浙江省医药卫生科技计划基金资助项目(2011D10018)

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 suppositories or pethidine or tramadol alleviates in the treatment of ureteral calculus colic. Methods A total of 150 patients with ureteral calculus colic were randomly divided into group A（ n = 55 ）, group B （ n = 53 ） and group C （n = 42）. Group A was received intravenous injection of anisodamine 10 rag, 1 -2 times a day, combined with the indomethacin suppositories 100 rag, anus, qd. Group B was received intravenous injection of anisodamine 10 rag, 1 -2 times a day, and intravenous injection of pethidine 75 rag, qd. Group C was received intravenous injection of ani- sodamine 10 mg, twice a day, combined with intramuscular injection of tramadol 100 mg, qd. Stay in emergency observation room 1 -3 d until stone discharge or pain relief. The patient whose stone＇ s diameter greater than 8 -10 mm turn to the department of ureteroscopy for stone treatment. The analge urology line lithotripsy or sic efficiency, recurrence rate, onset time, duration and adverse drug reactions were compared among three groups. Results Analgesic effective rates of group A, B, C were 90. 90% （50/55 cases）, 73.58% （39/53 cases）, 71.43% （30/42 cases）. The onset within 30 min of group A, B, C were 42 cases （76. 36% ）, 27 cases （50. 94% ）, 22 cases （52.38%）. Compared with B, C group, analgesic effective rate, recurrence rate and effect in 30 min cases of group A had statistically significant differences （ P 〈 0. 05 ）. The average maintenance time of group A, B, C were （28. 27 ± 0. 20）, （25.75 ± 0. 23）, （25.74 ±0.24） h, with significancedifference （P 〈0.01）. Adverse drug reactions include flushing, blurred vision, dry mouth, difficulty in urination, abdominal distension, dizziness, vomiting, nausea, addiction. The incidence of adverse drug reactions of group A, group B and group C were 5. 45% （3/55 cases）, 28. 30% （15/53 cases）, 26. 19% （11/42 cases）, with significant diff

关 键 词：输尿管结石 绞痛 吲哚美辛栓 哌替啶 曲马多 

分 类 号：R971.92[医药卫生—药品]