氢吗啡酮自控镇痛应用于子宫肌瘤动脉栓塞术的有效性和安全性  

Application of patient-controlled intravenous analgesia using hydromorphone in arterial embolization of uterine fibroids: evaluation of its efficacy and safety

作　　者：王艳丽[1] 赵毅 徐苗[1] 王艳玲 李松梅 方毅[1] 韩新巍[1] WANG Yanli;ZHAO Yi;XU Miao;WANG Yanling;LI Songmei;FANG Yi;HAN Xinwei(Department of Interventional Radiology,First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province 450052,China)

机构地区：[1]郑州大学第一附属医院放射介入科,450052

出　　处：《介入放射学杂志》2022年第10期962-965,共4页Journal of Interventional Radiology

摘　　要：目的 评价氢吗啡酮经静脉患者自控镇痛泵应用于子宫肌瘤动脉栓塞术(UAE)围手术期镇痛的有效性和安全性。方法 选取2021年6月至12月在郑州大学第一附属医院接受UAE术治疗的27例子宫肌瘤患者。将氢吗啡酮10 mg+0.9%氯化钠溶液配至100 mL镇痛泵中,术前15 min开始挂泵给药,术中根据患者疼痛情况调整用药剂量。采用疼痛数字评价量表(NRS)评估患者栓塞即刻、栓塞后5 min、手术结束时及术后6、12、24、48、72 h疼痛情况,并观察不良反应发生情况。结果 栓塞即刻、栓塞后5 min、手术结束时,术后6、12、24、48、72 h疼痛控制良好,中位住院时间为5 d,患者对镇痛治疗结果满意。术后简明疼痛评估量表(BPI)评分除“对行走能力的影响”与术前比较差异无统计学意义(P=0.861)外,其他生活质量评价项差异有统计学意义(均P<0.05)。5例(18.52%)发生不良反应,未发生呼吸抑制等严重不良反应。结论 子宫肌瘤动脉栓塞术中氢吗啡酮自控镇痛泵应用安全有效,可显著减轻患者疼痛并缩短住院时间。自控泵操作简便,不良反应发生率低,有一定的推广价值。Objective To evaluate the efficacy and safety of patient-controlled intravenous analgesia(PCIA) using hydromorphone for perioperative analgesia after uterine arterial embolization(UAE) of uterine fibroids. Methods A total of 27 patients with uterine fibroids, who underwent UAE at the First Affiliated Hospital of Zhengzhou University of China between June 2021 and December 2021,were enrolled in this study. Hydromorphone 10 mg plus normal saline was mixed into a 100 ml solution,which was put in the analgesic pump. The infusion of analgesic solution started at 15 minutes before surgery. The infusion velocity was adjusted according to the patient’s pain condition. The pain degrees at immediately after UAE, at 5 min after UAE, at the end of UAE, and at the postoperative 6 h, 12 h, 24 h, 48 h and 72 h were evaluated by usingnumerical rating scale(NRS), and the occurrence of side effects was recorded. Results At the time points of immediately after UAE, 5 min after UAE, the end of the operation, the postoperative 6 h, 12 h, 24 h, 48 h and 72 h, the patient’s pain was well controlled. The median hospital stay was 5 days and the patients were satisfied with the analgesic treatment. Postoperative brief pain assessment scale score of “influence on walking ability”, was not statistically significant different from preoperative one(P=0.861), and the differencesin all other evaluation indexes of quality of life between preoperative values and postoperative ones were statistically significant(all P<0.05). Five patients(18.52%) developed adverse reactions, and no serious adverse reactions such as respiratory depression, etc. occurred. Conclusion In UAE of uterine fibroids, PCIA using hydromorphone is clinically safe and effective, it can significantly reduce the pain degree and shorten the hospital length of stay.Moreover, PCIAis easy to operate with less adverse reactions. Therefore, this technique has a certain promotion value.(J Intervent Radiol, 2022, 31: 962-965)

关 键 词：子宫肌瘤 子宫动脉栓塞术 镇痛 氢吗啡酮 

分 类 号：R737.33[医药卫生—肿瘤]