两种方法治疗输尿管结石引起肾绞痛的疗效比较

目的分析盐酸坦索罗辛和硝苯地平与双氯芬酸钠联合用药治疗输尿管结石引起肾绞痛的疗效。方法365例输尿管结石肾绞痛患者随机分为两组。观察组应用坦索罗辛0.4mg口服,硝苯地平片10mg舌下含服,加双氯芬酸钠50mg口服益;对照组患者用阿托品0.5mg加哌替啶50～100mg肌内注射,两组均常规输液。分别在3O、60、120min及4h观察患者镇痛效果。结果用药后30min及60min时,观察组分别有93、44例有效,对照组分别有109、46例有效,两组比较差异无统计学意义（P〉0.05）。但于用药后120min时,观察组173例有效,对照组152例有效;在4h内完全缓解者观察组有162例,对照组有121例;复查B超,观察组共63例结石排出,而对照组只有26例结石排出。两组相比差异均有统计学意义（P〈0.001）。结论坦索罗辛、硝苯地平片加双氯酚酸钠组对肾绞痛缓解有效率明显优于阿托品、哌替啶组,其不良反应少,不受麻醉药品限制,还明显有利于结石的排出。

Compare Two Medical Treatments for Renal Colic Caused by Ureteral Calculi

Objective To compare the efficacy of the combined treatment with tamsulosin,nifedipine and diclofenac sodium for with injection with atropine and pethidine for renal colic caused by ureteral calculi.Methods 365 cases of ureteral calculi with renal colic patients were randomly divided into 2 groups.Observation group patients with oral 0.4 mg tamsulosin,nifedipine sublingual tablets 10 mg,50 mg diclofenac sodium,and control group patients intramuscular injection with atropine 0.5 mg and pethidine 50～100 mg. .Both groups provided with conventional intravenous infusion. Patients analgesic effect was observed at 30,60,120 rain and 4h. Results 30 rain and 60 rain after administration, observation group respectively have 93 and 44 cases effective, while the control group patients respectively have 109 and ＇$6 cases effective, but difference between the two groups was not significant （P〉 0.05）. At 120rain after administration, the observation group have 173 cases effective, while the control group have 152 cases effective. At 4h, with complete remission in the observation group was 162 cases, while control group was 121 cases. Review B-mode ultrasonography, expulsion of stones was observed in 63 eases of the observation group and 26 cases of the control group, with a significant difference （P〈0.001）. Conclusion Combine treatment with Tamsulosin, nifedipine, and Diclofenac Sodium is more effective than atropine and pethidine for renal colic, with fewer adverse reactions, free from restrictions on narcotic drugs, and also significantly in favor of expulsion of stones.