塞來昔布联合黄体酮对急性肾绞痛的观察1.docVIP

塞来昔布联合黄体酮对急性肾绞痛的观察 陈方慧 作者单位：310006 浙江杭州 杭州市第一人民医院急诊科 作者单位：310006 浙江杭州 杭州市第一人民医院急诊科 通讯作者：陈方慧，Email:chenfhui@ 【摘要】 目的： 探讨选择性COX-2抑制剂塞来昔布（西乐葆）加黄体酮对急性肾绞痛的疗效。方法： 采用单盲法随机给急性肾绞痛病人分成两组：观察组(n=60)以黄体酮40mg加西乐葆400mg治疗急性绞痛。对照组（n=57）以杜冷丁100mg加654-2 20mg治疗绞痛。分别以15min，30min，1h，2h，观察疼痛缓解度；两组药物副作用发生率。用药2天后血尿改变情况，采用软件SPSS10.0统计进行方差分析。结果： 两患者组在2h内疼痛缓解无统计学差异（P0.05），而副作用与血尿缓解情况有明显统计学意义（P0.05）；观察组优于对照组。结论： 对于急性肾绞痛，以黄体酮联合西乐葆治疗与以杜冷丁治疗效果相当，而副作用发生率低，结石下行时间缩短，并减少结石对输尿管壁的损伤。 【关键词】 急性肾绞痛；结石；黄体酮；杜冷丁；西乐葆 Investigation the therapy of acute renal colic with celebrex and progesterone CHEN Fang-hui,XIAO Chen,ZHOU Yue-ting，WANG Yi.Emergency Department,Hangzhou First Peoples Hospital,Hangzhou 310006,China Corresponding author:CHEN Fang-hui,Email:chenfhui@ [Abstract] Objective: To explore the curative effect of acute renal colic with celebrex and progesterone. Methods: The cases of acute renal colic were divided into two groups with single blind randomization: the observation group (n=60) was treated with celebrex 400mg and progesterone 40mg. The control group(n=57) was treated with pethidine 100mg and 654-2 20mg, then observing the curative effect and side reaction after 15min, 30min, 1h, 2h. Meanwhile the hematuria of cases was examined in 2d. The results were analysis of variance (ANOVA) with SPSS 10.0 Results: The odynolysis of two groups was not significant (P0.05), but the difference side reaction and hematuria was significant (P0.05). The therapy of observation group surpassed the control group. Conclusion: for acute renal colic, the curative effect was the same, using celebrex and progesterone or pethidine, but the former has more advantages, for example less side effect, less dropping time of calculus, and less injure ureter. [Key word] Acute renal colic; Calculus; Progesterone; Pethedine; Celebrex 输尿管结石是急诊外科的常见病，但对于输尿管结石所引起的急腹症治疗临床上常用阿片类药品或解痉药缓解肾绞痛。然而，单纯用解痉药常常难以奏效，应用阿片类药品虽可缓解肾绞痛。但有成瘾之虞。因此，进一步探究新的药物和新的治疗方法是必要的。本研究主要是针对输尿管结石患者的疼痛性质，采用选择性COX-2抑制剂类药物塞来昔布口服联合黄体酮肌注方法治疗急性肾