摘要
目的通过对我院急诊科急性肾绞痛治疗的回顾性分析,对常用的几种治疗药物组合进行比较,探寻治疗急性肾绞痛的最佳方案。方法急诊科640例急性肾绞痛确诊病例资料,根据我院常用的止痛方法分4组:①弱阿片类药(曲马多)+M受体阻滞剂(654-2);②NSAIDs(尼松)+M受体阻滞剂(654-2);③NSAIDs(尼松)+平滑肌解痉剂(间苯三酚);④强阿片类药物(哌替啶)+M受体阻滞剂(654-2)。评价给药30min内疼痛缓解的效果并进行分析。结果弱阿片类+M受体阻滞剂组显效率为64.80%(完全缓解),尼松+M受体阻滞剂(654-2)显效率为84.32%,尼松+平滑肌解痉剂(间苯三酚)显效率为84.78%,强阿片类+M受体阻滞剂组显效率88.89%,后三组的显效率无统计学差异,均优于第一组;12h复发率两组NSAIDs均低于与弱阿片类及强阿片类药物;不良反应率以尼松+间苯三酚组最低。结论尼松+M受体阻滞剂及尼松+间苯三酚可代替强阿片类药物治疗急性肾绞痛。
Objective To evaluate and analyses several methods of pain relief in severe renal colic patients through a retrospective analysis, and to search the informative one for clinic use. Methods A total of 640 cases of diagnosed severe renal colic were treated with different drugs respectively ： minor opioid （Tramadol） ＋M-receptor inhibitor, NSAIDs （Ketorolac Tromethamine） ＋ M- receptor inhibitor, NSAIDs （Ketorolac Tromethamine） ＋Phloroglucinol and major opioid （Pethidine） ＋ M-receptor inhibitor. Effects of pain relief（in 30 min）were evaluated by Verbal Rating Scale （VRS）. Results The excellence powers of tramadol＋M-receptor inhibitor, ketdrolac tromethamine＋M- receptor inhibitor,Ketorolac Tromethamine＋Phloroglucinoand and pethidine＋M-receptor inhibitor was 64.80%, 84.32%,84.78%,88.89% respectively, and the excellence powers of the latter three were higher significantly than that of the former, but there was no difference between the latter three. The relapse rates of the two NSAIDs were lower than the minor opioid and major opioid. As to the rate of adverse reaction in 12 hours, the NSAIDs ＋ Phloroglucinol was the lowest. Conclusion Application of Ketorolac Tromethamine ＋M-receptor inhibitor and Ketorolac Tromethamine ＋Phloroglucinol maybe a optimum choice in treating severe renal colic, instead of major opioid.
出处
《岭南现代临床外科》
2011年第5期371-373,共3页
Lingnan Modern Clinics in Surgery
基金
广东省自然科学基金(10151008901000135)
关键词
肾绞痛
疼痛缓解
急诊
药物治疗
Renal colic
Pain relief
Emergency department
Medication
