硬膜外连续泵入氢吗啡酮治疗亚急性带状疱疹性神经痛的效果  

Efficacy of continuous epidural hydromorphone for pain management in patients with subacute herpetic neuralgia

作　　者：黄琛[1] 卜慧莲[1] 焦鹏飞[1] 马民玉[1] 王涛[1] 孔存龙[1] 樊肖冲[1] HUANG Chen;BU Huilian;JIAO Pengfei;MA Minyu;WANG Tao;KONG Cunlong;FAN Xiaochong(Department of Pain Management,East District Hospital of the First Affiliated Hospital,Zhengzhou University,Zhengzhou 410105)

机构地区：[1]郑州大学第一附属医院郑东院区疼痛科,郑州410105

出　　处：《郑州大学学报（医学版）》2021年第4期544-547,共4页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金项目(81500964)。

摘　　要：目的:探讨氢吗啡酮经硬膜外自控镇痛治疗亚急性带状疱疹性神经痛的临床效果及不良反应。方法:将272例实施硬膜外镇痛的亚急性带状疱疹性神经痛患者分为氢吗啡酮组(H组,n=119)和吗啡组(M组,n=153),比较两组患者一般资料、数字化疼痛量表评分(NRS评分)、每日爆发痛发生次数、治疗期间患者自控镇痛次数和镇痛药物使用量、痛觉过敏状态、疼痛缓解程度及不良反应发生情况。结果:在硬膜外置管术后第7、14、30天,H组NRS评分和每日爆发痛发生次数均低于M组(P<0.05);H组患者痛觉过敏发生率低于M组(P<0.05);在治疗期间,H组患者自控疼痛次数和镇痛药物使用量小于M组(P<0.05);在术后第30天,H组患者疼痛缓解程度优于M组(P=0.009);H组恶心、呕吐和便秘发生率低于M组(P<0.05)。结论:氢吗啡酮经硬膜外泵入治疗亚急性带状疱疹性神经痛的镇痛效果及不良反应发生情况优于吗啡,具有良好的应用前景。Aim:To investigate the analgesic effects and adverse reactions of hydromorphone in the treatment of patients with subacute herpetic neuralgia(SHN)through patient controlled epidural analgesia.Methods:The clinical data of 272 SHN patients were analyzed retrospectively.The patients were allocated into two groups,group H(n=119)was epidurally injected with hydromorphone and group M(n=153)was epidurally injected with morphine.The numerical rating scales(NRS)and breakthrough frequency,patient controlled analgesia times,volume of drug used during treatment,hyperalgesia status,analgesia relief degree,and adverse reactions were collected for statistical analysis.Results:The NRS score and the breakthrough frequency of group H were lower than those of group M at the 7th,14th and 30th day(P<0.05).The number of hyperalgesia patients in group H was lower than that in group M at different time points(P<0.05).Patient controlled analgesia times and the volume of drug used in group H were less than those in group M during treatment period(P<0.05).The degree of analgesia relief of group H was better than that of group M(P=0.009).Moreover,the incident rate of adverse reactions of group H was less than that of group M(P<0.05).Conclusion:Hydromorphone has better analgesic effects and less adverse reactions than morphine in the treatment of SHN through epidural analgesia and could be used to treat SHN.

关 键 词：带状疱疹性神经痛 氢吗啡酮 吗啡 硬膜外镇痛 

分 类 号：R459.2[医药卫生—治疗学]