盐酸二氢埃托啡用于肝癌肝动脉化疗栓塞术中镇痛疗效评价  

The analgesic effect of dihydroetorphine in percutaneous hepatic artery chemoembolization therapy for liver cancer

作　　者：高银[1] 周波[1] 王建华[1] 刘嵘[1] 钱晟[1] 

机构地区：[1]上海复旦大学附属中山医院介入治疗科,200032

出　　处：《介入放射学杂志》2013年第11期904-907,共4页Journal of Interventional Radiology

摘　　要：目的 探讨肝癌肝动脉化疗栓塞（TACE）术中应用二氢埃托啡（DHE）的镇痛效果及术后疼痛的影响。方法 选择行介入治疗的肝癌患者120例，随机分为DHE组和对照组，DHE组在TACE开始时即给予舌下含服DHE 20 μg，必要时可加量至40 μg，对照组无特殊处理。视觉模拟评分法（visual analogue scale，VAS）作术前T0及术后0 ～ 12 h（T12）、12 ～ 24 h（T24）、24 ～ 48 h（T48）评分、记录患者主观舒适度（Bruggrmann comfort scale，BCS）评分及术后24 h内主动要求镇痛的人数及所用镇痛药的吗啡当量。结果 DHE组患者在TACE术后疼痛程度及控制较对照组好，术后T12、T24 治疗组VAS及BCS评分优于对照组。术中及术后无明显药物不良反应。结论 DHE用于肝癌患者TACE术中镇痛安全、有效。Objective To evaluate the analgesic effect of dihydroetorphine （DHE） on postoperative pain in transarterial chemoembolization （TACE） therapy for patients with liver cancers. Methods A total of 120 patients with hepatic cancer who was planed to receive interventional therapy were enrolled in this study. The patients were randomly divided into DHE group （n = 60） and control group （n = 60）. Patients of the DHE group sublingually took 20μg （or 40 μg if necessary） of DHE when TACE began, while no special medication was employed for patients of control group. Visual analogue scale （VAS） was used to quantitatively evaluate the scores of the base line （TO） and at 0 - 12 hours （T12）, 12 - 24 hours （T24） and 24 - 48 hours （T48） after the treatment. And Bruggrmann comfort scale （BCS） was used to evaluate the scores of subjective comfort level. The percentage of patients who asked for analgesic drug within 24 hours after TACE was calculated. Results After TACE the pain severity and paincontrol extent of the DHE group were much better than those of the control group. The VSA scores and BCS scores of both T12 and T24 of the DHE group were significantly superior to those of the control group. No obvious drug-related untoward reactions or sideeffects occurred during and after the operation. Conclusion For controlling pain in TACE for liver cancer, the use of D HE is safe and effective.

关 键 词：肝癌 二氢埃托啡 镇痛 肝动脉化疗栓塞术  

分 类 号：R735.7[医药卫生—肿瘤]