舒芬太尼患者皮下自控镇痛治疗难治性癌痛的临床观察  

Clinical observation of sufentanil in the treatment of refractory cancer pain with patient-controlled subcutaneous analgesia

作　　者：杜宝昌[1] 刘军[1] 肖芳芳[1] 杜羡 郭茜[1] Du Baochang;Liu Jun;Xiao Fangfang;Du Xian;Guo Qian(Department of Oncology,China National Petroleum Corporation Central Hospital,Langfang City,Hebei Province 065000,China)

机构地区：[1]中国石油天然气集团公司中心医院肿瘤科,河北省廊坊市065000

出　　处：《中华疼痛学杂志》2020年第2期119-122,共4页Chinese Journal Of Painology

摘　　要：目的探讨舒芬太尼患者皮下自控镇痛(PCSA)治疗难治性癌痛的效果及安全性。方法回顾性分析中国石油天然气集团公司中心医院肿瘤科于2017年7月至2018年6月诊治的26例难治性癌痛患者应用舒芬太尼PCSA治疗的临床资料。以枸橼酸舒芬太尼注射液原液或加入等量0.9%氯化钠溶液稀释后,加入电子自控镇痛泵。舒芬太尼PCSA负荷剂量2.5~5.0μg,背景剂量2.5~120.0μg/h,自控剂量2.5~120.0μg/次,以个体化参数持续皮下输注。分别以数字评定量表(NRS)和生活质量评分(QOL)评定患者治疗前和治疗后的疼痛和生活质量,记录患者不良反应。结果治疗前NRS评分(8.7±0.7),治疗后当日、第7日时NRS评分分别为(2.6±0.7)、(1.9±0.8),差异有统计学意义(P<0.001);治疗前QOL评分为(10.0±0.7),治疗1周后QOL评分为(16.0±1.2),治疗前后比较,差异有统计学意义(P<0.01)。未见严重不良反应。结论舒芬太尼PCSA是治疗难治性癌痛的有效方法,其安全、可靠,患者依从性好。Objective To investigate the efficacy and safety of patient-controlled subcutaneous analgesia(PCSA)with sufentanil in the treatment of refractory cancer pain.Methods The clinical data of 26 patients with refractory cancer pain treated with sufentanil PCSA in Department of Oncology,China National Petroleum Corporation Central Hospital,between July 2017 to June 2018 were retrospectively analyzed.The sufentanil citrate injections or its diluted liquid with an equal volume of 0.9%sodium chloride solution was added into an electronically controlled analgesia pump.The loading dose of sufentanil PCSA was 2.5-5.0μg,the background dose was 2.5-120.0μg/h,and the bolus dose was 2.5-120.0μg/time.The parameters of continuous subcutaneous infusion was individualized.The pain level and quality of life of patients before and after treatment were evaluated by numerical rating scale(NRS)and quality of life score(QOL)respectively.The adverse reactions were observed.Results The NRS was(8.7±0.7)before treatment,and(2.6±0.7)、(1.9±0.8)at the first and seventh days after treatment respectively,with statistically significant(P<0.001);The QOL score was(10.0±0.7)before treatment,and(16.0±1.2)after treatment,with statistically significant(P<0.01).No serious adverse reactions occurred.Conclusion Sufentanil PCSA is an effective and safe method for the treatment of patients with refractory cancer pain.

关 键 词：难治性癌痛 镇痛 病人控制 注射 皮下 皮下灌注术/皮下输液 舒芬太尼 治疗结果 安全性 

分 类 号：R730[医药卫生—肿瘤]