氨酚羟考酮片治疗肾绞痛的临床观察

目的探讨氨酚羟考酮片治疗肾绞痛的效果与安全性。方法回顾性分析肾绞痛患者280例，依据其治疗过程中是否使用氨酚羟考酮片分为治疗组（使用氨酚羟考酮组）和对照组（未使用氨酚羟考酮组）。应用VAS疼痛评分方法评价开始治疗前患者肾绞痛的疼痛严重程度（分为轻中重三度），NRS分级法评判疼痛治疗效果（分为0、1、2、3、4度缓解）。结果（1）治疗前VAS评分：治疗组轻度49例，中度63例，重度61例；对照组轻度27例，中度41例，重度39例。（2）治疗后30min，治疗组重度疼痛0度未缓解56例，1度轻度缓解5例；中度疼痛2度中度缓解55例，3度明显缓解7例，4度完全缓解1例；轻度疼痛4度完全缓解45例，3度明显缓解4例。对照组经“盐酸哌替啶注射液”或“盐酸布桂嗪注射液”肌内注射后，头30min重度疼痛4度完全缓解31例，3度明显缓解8例；中度疼痛者4度完全缓解38例，3度明显缓解3例；轻度疼痛者4度完全缓解27例。（3）治疗组中仅重度疼痛并在头30min0度未缓解者使用“盐酸哌替啶注射液”或“盐酸布桂嗪注射液”一次，之外其余所有患者在治疗过程中均未再使用“盐酸哌替啶注射液”或“盐酸布桂嗪注射液”；对照组107例患者共使用“盐酸哌替啶注射液”或“盐酸布桂嗪注射液”212例次，人均使用1．98次，使用次数最多的患者住院期间共注射7次，平均1b~／30．3h。（4）治疗组不良反应：恶心、呕吐2例，头晕、嗜睡9例，腹胀、便秘10例；对照组不良反应：头晕、嗜睡72例，腹胀、便秘10例。结论（1）氨酚羟考酮片对于中轻度肾绞痛的缓解作用优于重度。肾绞痛；（2）重度肾绞痛联合应用氨酚羟考酮片及“盐酸哌替啶注射液”或“盐酸布桂嗪注射液”既可以取得良好的效果，还可以显著降低后续治疗过程中需要重复使用“盐酸哌替啶注射液”或“盐酸布桂嗪注射液”的机会；（3）氨酚羟考酮片对于肾绞痛的治疗是安全、有效地，且使用更加方便。

Clinical observation of oxycodone acetaminophen in the treatment of nephric colic

Objective To explore the effect and security of oxycodone acetaminophen in the treatment of neph- tic colic. Methods The clinical data of 280 patients with nephric colic were retrospectively analyzed. The patients were divided into 2 groups according to using oxycodone acetaminophen during treatment or not （group A with oxycodone ac- etaminophen and group B without oxycodone acetaminophen）. VAS score was used to evaluate the grade of nephric colic pretherapy（ grade I,II and III）. NRS-elassification was used to judge odynolysis effect of nephric colic （grade 0,1,2,3 and 4）. Results VAS pretherapy in group A：grade Iinluded 49 cases, grade ]] 63 cases arid grade m 61 cases. VAS pretherapy in group B：grade Iincluded 27 cases,grade II 41 cases and grade m 39 cases. After treatment for 30min, odynolysis effect of nephric colic in group A was ： among 61 cases with grade m pain, 56 cases without any remission （grade 0） and 5 cases with slightly remission（ grade 1 ） ;among 63 cases with grade II pain ,55 cases with mezzo remis- sion（ grade 2）and 7 cases with obviously remission （ grade 3 ） and 1 ease with complete remision （ grade 4 ） ; among 49 cases with grade I pain ,4 cases with obviously remission（ grade 3 ） and 45 cases with complete remision （grade 4 ）. All cases in group B were treated with pethidine hydrochloride injection or bucinnazine hydrochloride injection. In the 1st 30min after the injection,among 39 cases with grade III pain,3l cases with complete remission（grade 4） and 8 cases with obviously remission（ grade 3 ） ;among 41 cases with grade II pain ,38 cases with complete remission（ grade 4） and 3 cases with obviously remission（ grade 3 ） ;all 27 cases with grade I pain with complete remission（ grade 4）. Pethidine hydrochloride injection or bucinnazine hydrochloride injection was used only once for without any remission（ grade 0） during the 1st 30rain after taking oxycodone aeetaminophen orally in group A. All of other cases without any injection during therapy. In group B, 107 cases were injected for 212 times. The maximum individual times were 7 times. The ad- verse reactions of group A included 2 cases of nausea and vomiting ,9 cases of dizziness and lethargy, 10 cases of abdom- inal distention and constipation. The adversereactions of group B included 72 cases of dizziness and lethargy, 10 eases of abdominal distention and constipation. Conehmions Oxycodone acetaminopben is more effective in the treatment of mild or midrange nephric colic（ grade I to II） than severe nephric colic（ grade m ）. Symphysial utilization of oxycodone acetaminophen and pethidine hydrochloride injection or bucinnazine hydrochloride injection will be more effective for se- vere nephric colic （grade m ）. And symphysial utilization can decrease the times of injection during the therapy. Finally, oxycodone acetaminophen is a safe and effective drug in treating nephric colic. And it is more convenient.