鞘内输注盐酸氢吗啡酮对癌性疼痛患者的镇痛效果临床分析  

Clinical analysis of analgesic effect of intrathecal infusion of hydromorphone hydrochloride on patients with cancer pain

作　　者：张平[1] 张轩搏 李仁淑[1] ZHANG Ping;ZHANG Xuanbo;LI Renshu(Department of Pain Management,Affiliated Hospital of Yanbian University,Yanji 133000,Jilin,China)

机构地区：[1]延边大学附属医院疼痛科,吉林延吉133000

出　　处：《延边大学医学学报》2024年第1期44-47,共4页Journal of Medical Science Yanbian University

基　　金：吉林省科技厅基础项目(项目编号:YDZJ202301ZYTS185);延边大学应用基础项目(项目代码:482021007)。

摘　　要：[目的 ]观察鞘内输注盐酸氢吗啡酮对癌性疼痛患者的镇痛效果.[方法 ]选择口服给予吗啡缓释片治疗改为鞘内植入盐酸氢吗啡酮泵术治疗的50例癌性疼痛患者作为研究对象,观察改变镇痛方式前后的疼痛评分、生活质量、用药量、24 h内爆发痛次数及阿片类药物导致的恶心、呕吐、戒断反应等不良反应发生情况.[结果 ]鞘内植入盐酸氢吗啡酮泵的50例癌性疼痛患者术后24 h的NRS评分明显降低(P <0.05),生活质量明显改善,恶心、呕吐等不良反应症状明显缓解.3例发生戒断反应;癌症发生骨转移与否与药物无相关性(P> 0.05),癌症骨转移患者术后用药量明显降低(P <0.05);癌症发生骨转移与否与爆发痛次数无相关性(P> 0.05),但术前癌症骨转移患者爆发痛次数呈增多趋势,术后爆发痛次数明显减少(P <0.05).[结论 ]鞘内植入盐酸氢吗啡酮泵可降低癌性疼痛患者的疼痛评分,减少用药量及24 h内爆发痛次数,降低恶心、呕吐等不良反应的发生率,患者生活质量提高,戒断反应发生率亦降低.OBJECTIVE To observe the analgesic effect of intrathecal infusion of hydromorphone hydrochloride on patients with cancer pain.METHODS Fifty patients with cancer pain who were treated with morphine sustained-release tablets by oral administration and then changed with intrathecal implantation of hydromorphone hydrochloride pump were selected as the study objects.The pain scores,quality of life,dosage,number of breakthrough pain within 24 hours and the occurrence of adverse reactions such as nausea,vomiting and withdrawal caused by opioids were observed before and after the change of analgesia mode.RESULTS The NRS scores of 50 patients with cancer pain decreased significantly 24 hours after intrathecal implantation of hydromorphone hydrochloride pump(P<0.05).The quality of life was significantly improved,and the adverse reactions such as nausea and vomiting were significantly alleviated,and withdrawal reaction occurred in 3 cases.There was no correlation between the occurrence of cancer bone metastasis and drug use(P>0.05).Postoperative drug dosage was significantly decreased in patients with cancer bone metastasis(P<0.05).There was no correlation between the occurrence of cancer bone metastasis and the number of breakthrough pain(P>0.05),but the number of breakthrough pain increased before surgery and decreased significantly after surgery in patients with cancer bone metastasis(P<0.05).CONCLUSION Intrathecal implantation of hydromorphone hydrochloride pump can reduce the pain scores,the dosage,the number of breakthrough pain within 24 hours,the incidence of adverse reactions such as nausea and vomiting,and improve the quality of life and reduce the incidence of withdrawal reactions in patients with cancer pain.

关 键 词：癌性疼痛 鞘内植入泵 盐酸氢吗啡酮 镇痛效果 

分 类 号：R614[医药卫生—麻醉学]