超声引导皮下自控镇痛在安宁疗护中的临床应用  

Effect of ultrasound-guided patient-controlled subcutaneous analgesia on the hospice care

作　　者：李丹 王叶纯 邹军 朱凌云[2] 张邓新 LI Dan;WANG Yechun;ZOU Jun;ZHU Lingyun;ZHANG Dengxin(Wuxi School of Medicine,Jiangnan University,Wuxi 214122,China;Department of Anesthesiology,Af-filiated hospital of Jiangnan University,Wuxi 214062,China;Department of Anesthesiology,Affiliated Wuxi Matemity and Child Health Care Hospital of Jiangnan University,Wuxi 214002,China)

机构地区：[1]江南大学无锡医学院,无锡214122 [2]江南大学附属医院麻醉科,无锡214062 [3]江南大学附属无锡妇幼保健院麻醉科,无锡214002

出　　处：《中国疼痛医学杂志》2022年第4期278-284,共7页Chinese Journal of Pain Medicine

基　　金：江苏省中医药科技发展计划项目(YB201945);无锡市卫生健康委科技成果和适宜技术推广项目(T201908)。

摘　　要：目的:观察超声引导皮下自控镇痛对晚期癌痛病人安宁疗护的临床效果。方法:90例晚期肿瘤病人,按随机数字表法分为皮下自控镇痛组(S组)、超声引导皮下自控镇痛组(U组)和静脉自控镇痛组(I组),每组30例。比较治疗前后疼痛数字评分法(numerical rating scale,NRS)评分、肿瘤病人生活质量评分(quality of life score,QOL)、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分及治疗期间不良反应。结果:治疗后第1天、3天,I组镇痛效果较好,但在治疗后第7天、14天,三组的镇痛效果相同;与I组相比,治疗后第3天、7天、14天,S组和U组QOL评分明显提高(P<0.05);且在治疗期间S组和U组睡眠质量PSQI评分改善效果最显著(P<0.05),不良反应发生率更低;U组穿刺点皮肤合并症发病率最小,三组之间比较差异均有统计学意义(P<0.05)。结论:超声引导皮下自控镇痛效果好、不良反应少、安全性高,可以明显改善病人的生活质量和睡眠质量,更适合用于晚期癌痛病人安宁疗护的治疗。Objective:To observe the clinical effect of ultrasound-guided patient-controlled subcutaneous analgesia on the hospice care of patients with advanced cancer pain.Methods:Ninety patients with advanced cancer were randomly divided into three groups:patient-controlled subcutaneous analgesia group(group S),ultrasound-guided patient-controlled subcutaneous analgesia group(group U)and patient-controlled intravenous analgesia group(group I),with 30 cases in each group.The numerical rating scale(NRS),quality of life score(QOL),Pittsburgh sleep quality index(PSQI)and adverse reactions were compared before and after treatment.Results:On the 1st and 3rd day after treatment,the analgesic effect of group I was the best,but there was no difference among the three groups on the 7th and 14th day after treatment.Compared with I group,the QOL of group S and group U increased significantly on the 3rd,7th and 14th day after treatment(P<0.05).During the treatment period,the improvement of PSQI in group S and group U was the most significant(P<0.05),and the incidence of adverse reactions were lower.Group U had the least incidence rate of skin complications,and the differences among the three groups were statistically significant(P<0.05).Conclusion:Ultrasound-guided subcutaneous patient-controlled analgesia has a good effect on cancer pain,less adverse reactions and good in security,which can significantly improve the quality of life and sleep quality of patients.It is more suitable for the treatment of patients with advanced cancer pain.

关 键 词：超声 皮下自控镇痛 晚期癌痛 安宁疗护 

分 类 号：R48[医药卫生—临床医学]