氯诺昔康/盐酸戊乙奎醚用于治疗输尿管结石引起急腹痛的观察

Treatment efficacy of lornoxicam/penehyclidine for ureterolith-induced colic

目的比较氯诺昔康联合盐酸戊乙奎醚(penehyclidine hydrochloride)用于输尿管结石所引起的急腹痛的疗效和病理生理影响。方法60例输尿管结石急腹痛患者随机均分成三组:氯诺昔康组(L组)、盐酸戊乙奎醚组(P组)、氯诺昔康/盐酸戊乙奎醚组(L/P组)。L组氯诺昔康8mg肌注;P组盐酸戊乙奎醚1mg肌注;L/P组氯诺昔康8mg/盐酸戊乙奎醚1mg肌注。记录患者使用镇痛药后疼痛缓解时间及首次再痛发生时间;行注射前后疼痛评分;观察不良反应的发生率。用药后3周行腹部平片及尿常规复查,观察结石下行和输尿管损伤情况。结果三组患者用药后疼痛均能缓解,L/P组镇痛效果最佳;L/P组疼痛缓解时间明显短于其他两组,首次再痛发生时间明显长于其他两组,有明显的节镇痛药效应。3周后腹部平片或超声检查显示L/P组患者的结石下行速度快于其他两组,血尿改善也比其他两组满意。结论对于输尿管结石性急腹痛,氯诺昔康和盐酸戊乙奎醚的联合使用比两者单独使用显示出更加迅速而又持久的镇痛作用,有效的解痉镇痛治疗有利于输尿管结石的下行,并可减少结石对输尿管壁的损伤。

Objective To evaluate the treatment efficacy of lornoxicam/penehyclidine for ureterolith-induced colic. Methods Sixty patients with ureterolith-induced colic were randomly allocated into three groups. The patients in group L received intramuscularly injection of lornoxlcam 8 mg, in group P of penehyclidine 1 mg and in group L/P of lornoxicam 8 mg combined with penehyelidine 1 mg, respectively. The analgesic efficacy （at the time points of before intramuscularly injection, 15, 30, 45 rain, 1, 2 and 4 h after intramuscularly injection）, the time of pain relief, the time interval of pain recurrence, the total consumption of analgesics, and the side effects of analgesics were evaluated. Three weeks late, X-ray of abdomen and urine analysis were examined to detect ureterolith and hematuria respectively. Results Although all patients in three groups were achived with a definite pain relief,the patients in group L/P presented the best analgesic efficacy. The time of total pain relief in group L/P was significantly shorter than that in group L and group P. The time interval of pain recurrence in L/P was significantly longer than that in group L and group P. The consumption of analgesics in group L/P was significantly less than that in group L and group P. The X-ray of abdomen demonstrated that the ejection of ureteral calculus in group L/P was faster than that in group L and group P. The examination of urine showed that the hematuria in L/P was less than that in group L and group P. Conclusion Lornoxicam/penehyelidine can relieve the colic pain quicker and longer than lornoxieam or penehyclidine alone. Effective analgesic treatment may enhance the ejection of ureteral calculus and reduce the injury of ureter from ureteral calculus.