不同途径吗啡给药方式对癌症晚期患者爆发痛干预效果研究  

Different ways of morphine administration on outbreak of pain in patients with advanced cancer and the prognosis of pain intervention

作　　者：刘义楠 蒲艳春[1] 崔静茹[1] 杨宏[1] 周颖 LIU Yi-nan,PU Yan-chun,CUI Jing-ru,YANG Hong,ZHOU Ying(Pharmaceutical Division of Medicine Department,The Fourth Hospital Affiliated to Harbin Medical University,Harbin 150000,Chin)

机构地区：[1]哈尔滨医科大学附属第四医院药学部调剂科,黑龙江哈尔滨150000

出　　处：《创伤与急危重病医学》2018年第3期129-131,134,共4页Trauma and Critical Care Medicine

基　　金：黑龙江省卫生厅科研课题(2013103)

摘　　要：目的探讨吗啡不同给药途径对癌症晚期爆发痛患者疼痛干预的效果。方法选取自2010年1月至2016年12月在哈尔滨医科大学附属第四医院就诊的103例癌症晚期患者为研究对象。将患者随机分为A组(n=34)、B组(n=34)和C组(n=35)。其中,A组口服给药,B组直肠给药,C组静脉给药,观察并记录3组患者用药前后的疼痛评分、治疗有效率及不良反应发生情况。结果 3组患者用药后疼痛评分均明显低于用药前,差异有统计学意义(P<0.05);用药后A组与B组疼痛评分比较,差异无统计学意义(P>0.05),但C组用药后评分明显低于A、B两组,组间比较,差异有统计学意义(P<0.05)。A组患者治疗有效率为47.1%(16/34),B组为55.9%(19/34),C组为62.9%(22/35),C组的有效率显著高于A、B两组,组间比较,差异有统计学意义(P<0.05)。3组患者不良反应发生率比较,差异均无统计学意义(P>0.05)。结论硫酸吗啡控释片经口服给药、直肠给药和静脉给药,对晚期癌症患者的爆发痛均有一定的疗效,能有效缓解患者的疼痛,尤其是静脉给药,能明显缓解疼痛,同时不增加不良反应。Objective To investigate different ways of morphine administration on outbreak of pain in patients with advanced cancer and the prognosis of pain intervention. Methods A retrospective study was performed on 103 cases of patients with advanced cancer who were admitted from January 2010 to December 2016. Patients were randomly divided into Group A（ n = 34）,Group B（ n = 34） and Group C（ n = 35）. Patients of Group A were given oral administration of the drug,patients of Group B were given rectal administration,and patients of Group C were given intravenous administration,the pain scores of the three groups of patients before and after the medication,and the curative rate and adverse reactions were observed and recorded. Results After administration,the pain scores in patients of the 3 groups were significantly lower than those before the mediation（ P〈0. 05）; the pain scores between Group A and Group B had no statistically significant difference（ P〈0. 05）,while the pain score in Group C was significantly lower than that in Group A and Group B（ P〈0. 05）. The curative rate in Group C（ 62. 9%） was significantly higher than that in Group A（ 47. 1%） and Group B（ 55. 9%）,and the difference among the groups had statistically significance（ P〈0. 05）. The adverse reactions had no statistically significant difference among the 3 groups（ P〈0. 05）. Conclusion Morphine administrated by oral,rectal and veins,all has a certain curative effect on the outbreak of pain in patients with advanced cancer,which can effectively reduce the pain of patients,especially the intravenous drug delivery,can obviously improve curative effect and relieve pain without increase adverse reactions.

关 键 词：吗啡 给药方式 癌症爆发痛 效果观察 

分 类 号：R614[医药卫生—麻醉学]