酮咯酸氨丁三醇联合盐酸哌替啶治疗肾绞痛的临床观察

Clinical Observation of Ketorolac Tromethamine Combined with Pethidine Hydrochloride in the Treatment of Renal Colic

目的:观察酮咯酸氨丁三醇联合盐酸哌替啶治疗肾绞痛的临床疗效。方法:将我院2008年5月-2010年5月收治的中、重度疼痛的肾绞痛患者120例随机均分为3组,均采取肌肉注射药物进行镇痛治疗。其中,Ⅰ组应用酮咯酸氨丁三醇60mg;Ⅱ组应用盐酸哌替啶100mg;Ⅲ组应用酮咯酸氨丁三醇30mg+盐酸哌替啶50mg。记录用药前以及用药后3h内(0、0.5、1、1.5、2、2.5、3h)的疼痛强度、疼痛强度差、疼痛缓解度以判断镇痛效果,并观察各组治疗中的不良反应情况。结果:用药后,3组均在0.5h起效,在中度疼痛的镇痛方面,Ⅲ组在用药3h内的所有观察点均优于Ⅰ、Ⅱ组(P<0.05),在2h时差异最为显著(P<0.01);在重度疼痛的镇痛方面,Ⅲ组在用药1.5、2、2.5、3h时效果优于Ⅰ、Ⅱ组(P<0.05);Ⅲ组的中度以上疼痛缓解程度除0.5h外,其余各点与Ⅰ、Ⅱ组比较,差异均有统计学意义(P<0.05)。Ⅲ组不良反应的发生率小于其他2组(P<0.05)。结论:酮咯酸氨丁三醇联合盐酸哌替啶治疗肾绞痛效果显著,同时可减少盐酸哌替啶的使用量,并可延长镇痛时间,且安全性较好。

OBJECTIVE： To observe the analgesic effects of ketorolac tromethamine and pethidine hydrochloride in the treatment towards renal colic. METHODS： 120 presenting moderate and severe pain of renal colic patients who were received and treated by our hospital during the May 2008 to May 2010. The qualified cases were randomly divided into 3 groups, 40 cases each and given intramuscular injection： Group I , ketorolac tromethamine 60 mg; Groupl, pethidine hydrochloride 100 mg; Group Ill, ketorolac tromethamine 30 mg＋pethidine hydrochloride 50 mg. Pain intensity （PI）, pain intensity difference （PID）, pain relief （PAR） and adverse reaction were recorded by the observer before and within 3 h （0, 0.5, 1, 1.5, 2, 2.5, 3 h） of using the drug in order to evaluate the analgesic effect. RESULTS： 3 groups were all onset of analgesia 0.5 h after the injection. In terms of moder- ate pain, Group 11I showed a better improvement for all observation points within 3 h than Group I , II （P〈0.05）, and more significantly at 2 h （P〈0.01）. In terms of severe pain, Group Ill showed a better improvement than Group I , II at the point of 1.5, 2, 2.5, 3 h with statistically significant difference （P〈0.05）. Despite the point 0.5 h, there was a statistically significant differenc- es between Group III and Group I , I on the degree of moderate relief （P〈0.05）. The incidence of adverse reactions of Group ~I was less than the other 2 groups （P〈0.05）. CONCLUSIONS： The combination mode of ketorolac tromethamine and pethidine hydrochloride performed a remarkable effects, better than the 2 drugs used alone. The combination mode not only reduced the dose of pethidine hydrochloride ,but also extended duration of analgesia, which was an effective treatment of renal colic with good safty.