Cole R S, Palfrey E L, Smith S E, Shuttleworth K E
Lithotripter Centre, St. Thomas' Hospital, London, England.
J Urol. 1989 Jan;141(1):9-12. doi: 10.1016/s0022-5347(17)40570-2.
Ureteral colic occurs in 24 to 34 per cent of all patients following extracorporeal shock wave lithotripsy. Recent research has shown prostaglandin synthetase inhibitors to be effective in relieving the pain associated with ureteral colic. Our prospective, controlled, double-blind, randomized study was designed to test the efficacy of indomethacin in the prophylactic treatment of pain after extracorporeal shock wave lithotripsy. Patients undergoing extracorporeal shock wave lithotripsy were randomized into 2 groups. Group 1 received 100 mg. indomethacin suppositories twice daily and group 2 received placebo suppositories. After extracorporeal shock wave lithotripsy 2 analgesics were available to the patients: oral co-dydramol or intramuscular pethidine was offered in the normal manner by the nursing staff. The pre-extracorporeal shock wave lithotripsy x-ray was used to make a quantitative estimate of the total stone burden in each patient. The post-extracorporeal shock wave lithotripsy analgesic requirement was used to compare the 2 groups. Of 112 patients recruited to the study 55 received indomethacin and 57 received placebo. The request for analgesia in the 2 groups was not different (28 of 55 and 33 of 57, respectively). However, in the indomethacin group only 6 patients required pethidine (10 doses), compared to 18 (41 doses) in the placebo group. This difference is statistically significant (p less than 0.01). There was no difference between the 2 groups in the occurrence of ureteral steinstrasse. Indomethacin has been shown to be effective in the prophylactic treatment of ureteral colic after lithotripsy.
在所有接受体外冲击波碎石术的患者中，24%至34%会发生输尿管绞痛。最近的研究表明，前列腺素合成酶抑制剂可有效缓解与输尿管绞痛相关的疼痛。我们的前瞻性、对照、双盲、随机研究旨在测试吲哚美辛在体外冲击波碎石术后预防性治疗疼痛的疗效。接受体外冲击波碎石术的患者被随机分为两组。第1组每天两次接受100毫克吲哚美辛栓剂，第2组接受安慰剂栓剂。体外冲击波碎石术后，患者可使用两种镇痛药：护理人员按常规方式提供口服双氢可待因或肌肉注射哌替啶。体外冲击波碎石术前的X线片用于对每位患者的总结石负荷进行定量评估。通过体外冲击波碎石术后的镇痛需求来比较两组。在招募到该研究的112名患者中，55名接受吲哚美辛治疗，57名接受安慰剂治疗。两组的镇痛需求无差异（分别为55名中的28名和57名中的33名）。然而，在吲哚美辛组中只有6名患者需要哌替啶（10剂），而安慰剂组有18名患者（41剂）。这种差异具有统计学意义（p小于0.01）。两组在输尿管石街的发生率上没有差异。已证明吲哚美辛在碎石术后预防性治疗输尿管绞痛方面有效。
