摘要
目的 观察氢吗啡酮患者自控静脉镇痛治疗中、重度癌痛患者的疗效及对生活质量的影响.方法 收集2020年1月1日至2021年10月31日期间山西省汾阳医院肿瘤内科收治的中重度癌痛患者92例,按照数字表法随机分为口服羟考酮药物组(口服药物组)和氢吗啡酮患者静脉自控镇痛组(自控镇痛组),每组46例.口服药物组患者给予羟考酮缓释片镇痛方案,自控镇痛组患者给予氢吗啡酮自控镇痛方案.评估并比较两组患者治疗前和治疗后7 d的疼痛数字等级评分(NRS)、自陈式问卷-心理痛苦温度计法评分(PDT)、癌症相关性疲乏评估量表(CRF)评分、癌症患者生活质量测定量表评分.比较两组患者治疗后嗜睡、恶心呕吐、纳差、尿潴留等不良反应发生情况.结果 与治疗前比较,治疗后7 d时,两组患者NRS、PDT、CFS与生活质量各维度评分均降低,差异均有统计学意义(P均＜0.05).与口服药物组比较,治疗后7 d时,自控镇痛组患者NRS、PDT、CFS及生活质量各维度评分均降低,差异均有统计学意义(P均＜0.05).与口服药物组比较,治疗后7 d时,自控镇痛组患者嗜睡、恶心呕吐、纳差、尿潴留及总发生率均降低,差异有统计学意义(P均＜0.05).结论 氢吗啡酮患者自控镇痛治疗中、重度癌痛安全有效,并可有效改善晚期癌痛患者的心理痛苦、癌症相关性疲乏及生活质量.
Abstract
Objective To study and explore the analgesic effect of patient-controlled intravenous analgesia with hydromorphone on moderate to severe cancer pain patients and its impact on quality of life.Methods Ninety-two patients with moderate to severe cancer pain admitted to the Department of Oncology,Fenyang Hospital in Shanxi Province from January 1,2020 to October 31,2021 were collected,and randomly divided into oral oxycodone medication group(oral medication group)and intravenous patient-controlled analgesia group(patient-controlled analgesia group)using a digital table method,with 46 patients in each group.The patients in the oral medication group were given slow-release oxycodone tablet analgesic regimen,while the patients in the patient-controlled analgesia group were given patient-controlled hydromorphone analgesic regimen.The pain numerical rating scale(NRS),psychological distress thermometer(PDT),cancer-related fatigue rating(CRF)and quality of life scale(QOL)were evaluated and compared between the two groups before and 7 days after treatment.The incidence of side effects such as drowsiness,nausea,vomiting,anorexia and urinary retention were compared between the two groups.Results Compared with before treatment,at 7 days after treatment,the scores of NRS,PDT,CFS and in all dimensions of QOL decreased in both groups of patients,and the differences were all statistically significant(all P＜0.05).Compared with the oral medication group,at 7 days after treatment,the scores of NRS,PDT,CFS,and QOL in the patient-controlled analgesia group were lower,with statistically significant differences(all P＜0.05).Compared with the oral medication group,at 7 days after treatment,the incidence of drowsiness,nausea and vomiting,anorexia,urinary retention and the total incidence of patients in the patient-controlled analgesia group were lower,with a statistically significant difference(all P＜0.05).Conclusions Patient-controlled analgesia with hydromorphone is safe and effective in treating moderate to severe cancer pain,and can effectively improve the psychological pain,cancer-related fatigue,and quality of life for patients with advanced cancer pain.
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