家居晚期癌痛病人的姑息性镇静治疗  

Study on the home palliative sedation to patients with advanced cancer in refractory pain

作　　者：李奕[1] 张川[1] 李金祥[1] 姜倩[2] 蒋建军[1] 杨超[3] 陈慧平[1] 

机构地区：[1]四川大学附四医院,四川成都610021 [2]四川大学华西公共卫生学院统计教研室 [3]泸州医学院公共卫生系

出　　处：《现代预防医学》2012年第6期1567-1569,共3页Modern Preventive Medicine

摘　　要：目的分析对晚期癌痛患者的痛苦症状进行家居镇静治疗的可行性和有效性。方法选择我院收治的家居晚期癌痛患者240例,将研究对象随机分为2组,Ⅰ组118例,Ⅱ组122例。Ⅰ组采用基础吗啡剂量加口服吗啡剂量30mg/kg,Ⅱ组采用基础吗啡加口服吗啡剂量30mg/kg+阿普唑仑0.4mg。1周后评价疼痛评分值及MDASI评分值改变情况。结果①两组病例基本特征分布情况是均衡分布的,具有良好的可比性;②两组间疼痛评分差值的差异有统计学意义(P﹤0.001)。两组间综合评分差值的差异有统计学意义(P﹤0.001)。结论①吗啡联合镇静药对家居癌痛患者的镇痛效果明显优于单用吗啡。②吗啡联合镇静药能较好的控制癌症患者的痛苦症状。③家居癌痛患者短期镇静治疗具有较好的可行性及有效性。OBJECTIVE To analyze the patients with advanced cancer, who were in refractory pain and treated with home pal- liative sedation, and analyzed the feasibility and validity of the home sedation therapy. METHODS A total of 240 patients who were diagnosed as advanced cancer were selected from our hospital for home medical treaunent. The subjects were randomly di- vided into 2 groups of 118 cases for Groupl and 122 for Group 2. Group 1 was to maintain the same dose of morphine base and increase oral morphine dose 30mg/kg, while Group 2 was to maintain the same dose of morphine base but increase oral mor- phine dose 30 mg/kg as well as oral Midazolam 0.4 nag. We evalted the changes of the scores on the NRS and the M.D. Ander- son Syptom Iventory （MSASI）. RESULTS ① The statistical analysis of the distribution of the basic characteristic was even, and the two groups had good comparability.② The changes of the scores on the NRS had statistically significant difference （P 〈 0.001 ） , and MSASI resulted statistically significant difference （P 〈 0.001）. CONCLUSION ① Morphine combination with sedative was superior than single using morphine to the patients＇ home treatment of refractory cancer pain. ② Morphine with sedative combination was a better way to control the patients＇ anguish symptoms. ③Home sedation therapy took on a better fea- sibility and validity to patients with advanced cancer.

关 键 词：晚期癌症 疼痛 痛苦症状 姑息性镇静 

分 类 号：R730.7[医药卫生—肿瘤]