妊娠期顽固性肾绞痛的急诊处理

Emergency treatment of refractory renal colic during pregnancy: our experience in 21 patients

目的探讨妊娠期顽固性肾绞痛的急诊保守治疗方法和可行性。方法回顾性总结21例妊娠合并顽固性肾绞痛的病例，首先肌注山莨菪碱（654．2）10mg和黄体酮20mg，再静脉滴注间苯三酚80mg，常规给予25％硫酸镁静脉滴注，同时注意镁中毒，必要时哌替啶75～100mg肌注；合并感染及时使用敏感抗生素。结果21例患者症状均获缓解，11例在妊娠期内再次发生肾绞痛，再予同样保守治疗后症状缓解，除1例流产（习惯性流产，非结石引起）外，所有患者均顺利渡过围产期顺产或剖腹产。结论急诊保守治疗妊娠期合并顽固性肾绞痛方法安全可行，疗效良好，值得推广。

Objective To investigate the efficacy of emergency treatment for refractory renal colic during pregnancy. Methods A retrospective analysis was performed on 21 pregnant patients referred to our emergency department between June 2012 and July 2003 with refractory renal colic. Anisodamine was firstly given intramuscularly at a dose of 10 mg, and progesterone 20 rag, Then phlorogilucinol was given intravenously at a dose of 80 mg, magnesium sulfate injection was used by infusion. Pethidine was given intramuscularly at a dose of 75 mg to 100 mg on occasion. Antibiotic was timely used for concomitant infection. Results Twenty-one pregnant patients were all relieved by emergency treatment. Eleven of them were treated successfully when they were in refractory renal colic again. Twenty patients （1 case of miscarriage） were smoothly through the perinatal period. Conclusions In the treatment of refractory renal during pregnancy, conservative treatment of emergency may possesses a better analgesic effect and less side effects.