硬膜外置管镇痛泵给药在妇科肿瘤组织间插植近距离放疗中的镇痛疗效观察  

Observation of analgesic efficacy of epidural catheter analgesia pump in interstitial brachytherapy of gynecological tumor

作　　者：马一鸣 张明川 陈慧敏 武豪 郭大鹏 陈昊 谢广伦 程淑霞 MA Yiming;ZHANG Mingchuan;CHEN Huimin;WU Hao;GUO Dapeng;CHEN Hao;XIE Guanglun;CHENG Shuxia(Department of Gynecology,the Affiliated Cancer Hospital of Zhengzhou University&Henan Cancer Hospital,Henan Zhengzhou 450008,China;Department of Pain Rehabilitation and Palliative Medicine,the Affiliated Cancer Hospital of Zhengzhou University&Henan Cancer Hospital,Henan Zhengzhou 450008,China)

机构地区：[1]郑州大学附属肿瘤医院(河南省肿瘤医院)妇科,河南郑州450008 [2]郑州大学附属肿瘤医院(河南省肿瘤医院)疼痛康复与姑息医学科,河南郑州450008

出　　处：《现代肿瘤医学》2023年第6期1123-1126,共4页Journal of Modern Oncology

基　　金：河南省医学科技攻关项目(编号:LHGJ20200191)。

摘　　要：目的:探讨硬膜外置管镇痛泵给药应用于妇科肿瘤组织间插植近距离放疗的有效性和安全性。方法:选取行组织间插植近距离放疗的妇科肿瘤患者50例,其中25例行硬膜外置管连接自控镇痛泵镇痛(麻醉组),25例行肌注曲马多止痛(对照组)。应用疼痛数字分级法评分表(NRS)、EORTC QLQ-C30评分、状态-特质焦虑问卷(STAI)及IES-R事件冲击量表对患者感受定量分析。结果:麻醉组的平均NRS评分[(2.04±1.74)分]明显低于对照组[(5.44±2.35)分](P<0.05),状态焦虑问卷(SAI)、特质焦虑问卷(TAI)评分结果均优于对照组(P<0.05)。EORTC QLQ-C30评分麻醉组躯体、情绪、角色、社会及认知功能、总健康状况高于对照组,疼痛、气促、恶心与呕吐、食欲丧失评分低于对照组,差异均有统计学意义(P<0.05)。麻醉组IES-R评分低于对照组(P<0.05)。治疗后对照组中的止吐药物使用次数明显高于麻醉组(P<0.05)。两组均未出现呼吸抑制、谵妄、尿潴留等不良反应及延迟出院。结论:在妇科肿瘤组织间插植近距离放疗中应用硬膜外置管镇痛泵给药止痛效果显著,明显改善患者治疗期间舒适度及生活质量,无明显不良反应。Objective:To investigate the efficacy and safety of epidural catheter analgesia pump applied to interstitial brachytherapy of gynecological tumor.Methods:50 cases of gynecological tumors who underwent interstitial brachytherapy were selected.Among them, 25 cases were treated with epidural catheter connected to patient-controlled analgesia pump for analgesia(anesthesia group) and 25 cases were received intramuscular tramadol for pain relief(control group).The pain numerical rating scale(NRS),EORTC QLQ-C30 score, state-trait anxiety inventory(STAI) and IES-R event impact scale were used to quantitatively analyze the patients’ feelings.Results:The average NRS score of the anesthesia group was(2.04±1.74) scores, which was significantly lower than that of the control group[(5.44±2.35) scores](P<0.05),and the state anxiety inventory(SAI) and trait anxiety inventory(TAI) scores were better than those of the control group(P<0.05).The EORTC QLQ-C30 scores of physical, emotional, role, social and cognitive function, and overall health status of the anesthesia group were higher than that of the control group, and the scores of pain, shortness of breath, nausea and vomiting, and loss of appetite were lower than those of the control group, and the differences were statistically significant(P<0.05).The IES-R score of the anesthesia group was lower than that of the control group(P<0.05).After treatment, the frequency of antiemetic drug use in the control group was significantly higher than that in the anesthesia group(P<0.05).There were no adverse reactions such as respiratory depression, delirium, urinary retention and delayed discharge in both groups.Conclusion:The application of epidural anesthesia in interstitial brachytherapy of gynecological tumor has a significant analgesic effect, significantly improves the comfort and quality of life of patients during treatment, and has no obvious adverse reactions.

关 键 词：组织间插植 近距离放疗 硬膜外置管镇痛泵给药 疼痛 

分 类 号：R737.3[医药卫生—肿瘤]