Prcić Alden, Aganović Damir, Junuzović Dzelaludin, Kulovac Benjamin
Uroloska Klinika, Klinicki Centar Univerziteta u Sarajevu.
Med Arh. 2006;60(6 Suppl 1):37-40.
Renal colic represents the the collection of the acute symptoms which are characterized by very intensive and antagonizing pain, so, that withstanding, it calls for fast diagnosis and precise and speedy treatment. Intervention in renal colic cases has to be based on the knowledge on the origin of pain, renal damage suffered, and also has to protect the kidney from any damaged caused by the prolonged obstruction.
This paper presents the results from prospective, analitical, comparative, ITT (intention to treat) study that has been carried out 200 ambulatory treated seperate patients with renal colic, divided into four groups, in the time period from year 2003 to 2005. In all these cases the the efficiency and the active time time of standard medications used with renal colic symptoms.
2 grams of Metamizol i.v. and 75 mg of Diclofenac i.m. have shown equal efficiency in pain relief, which is 6 hours after the administration of therapy, while 50 mg of Butylscopolamin i.v. requires additional analgesic treatment (p < 0.05). The effect of Metamizol is a bit stronger 15 minutes after the application than the rest of the medications, but 30 minutes after the application the effects of Metamizol and Diclofenac are almost identical. Using meta analasys and EBM (Evidence Based Medicine) parameters in regard to the side effects, the made conclusion was that Diclofenac is the medication of choice for renal colic. Reserve medication is Metamizol, while Butylscopolamin causes negative side effects in 84% of the cases, and in 24% of the cases it causes cupping of the renal colic.
肾绞痛是一系列急性症状的集合，其特点是疼痛剧烈且呈绞痛性质，因此，忍受这种疼痛需要快速诊断以及精确和迅速的治疗。对肾绞痛病例的干预必须基于对疼痛来源、肾脏所受损伤的了解，并且还必须保护肾脏免受长时间梗阻造成的任何损害。
本文介绍了一项前瞻性、分析性、对比性、意向性治疗（ITT）研究的结果，该研究于2003年至2005年期间对200例门诊治疗的肾绞痛患者进行，分为四组。在所有这些病例中，研究了用于肾绞痛症状的标准药物的疗效和起效时间。
静脉注射2克安乃近和肌肉注射75毫克双氯芬酸在缓解疼痛方面显示出相同的疗效，即在治疗给药后6小时，而静脉注射50毫克丁溴东莨菪碱则需要额外的镇痛治疗（p<0.05）。安乃近在用药后15分钟的效果比其他药物稍强，但用药后30分钟，安乃近和双氯芬酸的效果几乎相同。使用荟萃分析和循证医学（EBM）关于副作用的参数，得出的结论是双氯芬酸是肾绞痛的首选药物。备用药物是安乃近，而丁溴东莨菪碱在84%的病例中会产生负面副作用，在24%的病例中会导致肾绞痛加剧。
