摘要
目的:探究氯胺酮对神经外科住院长期慢性癌痛患者吗啡耐受性影响。方法:选取2014年8月—2016年8月在平舆县人民医院、桂林医学院附属医院、广西医科大学附属肿瘤医院三家医院神经外科住院的中重度癌痛患者为研究对象,共90例患者,通过静脉自控镇痛的方式,将患者随机分为联合氯胺酮应用的观察组和单纯应用吗啡的对照组两组患者进行研究,对比两组镇痛及不良反应发生情况,研究氯胺酮对吗啡耐受的临床治疗效果。近年来国内外学者应用PCIA缓解癌痛效果较好,但是关于镇痛药物耐受性及如何降低其耐受性的研究仍较少。结果:对照组和观察组患者D1/D2比率和疼痛视觉模拟评分比较具有统计学差异(P<0.05);吗啡总用量的比较具有统计学差异(P<0.05);Ramsay镇静评分比较没有统计学差异(P≥0.05);两组患者皮肤瘙痒、尿潴留、呼吸抑制、幻觉等并发症比较具有统计学差异(P<0.05)。结论:氯胺酮联合吗啡静脉自控镇痛(PCIA)的方式对慢性癌痛患者吗啡耐受的减少有效,镇痛效果增强且每日吗啡总用量减少,不良反应发生率下降。
Objective:To study the effects of Ketamine in reducing morphine tolerance in neurosurgery.Methods:90cases of patients with severe rectum cancer pain from august2014-August2016in the hospital for treatment were collected as the research object,among them45cases were treated with PCIA of morphine,45cases were treated with PCIA of morphine and ketamine,the treatment effects of morphine tolerance were observed.Results:Ramsay scores have no statistically significant difference P<0.05);D1/D2,urinary retention,pruritus,respiratory depression,and hallucination have statistically significant difference(P<0.05).Conclusion:Ketamine(PCIA)can reduce the mechanisms of morphine tolerance,reduce morphine dosage,increased analgesic effect,decrease the incidence of adverse reactions.
作者
王华龙
朱敏
李爱国
WANG Hua-long;ZHU Min;LI Ai-guo(Neurosurgery of Pingyu People's Hospital, Zhumadian Henan 463400,China;Anesthesia of Affiliated Tumor Hospital of Guangxi Medical University, Nanning Guangxi 530000,China;Anesthesia of Affiliated Hospital of Guilin Medical University, Guilin Guangxi 541000, China)
出处
《药品评价》
CAS
2017年第14期22-25,42,共5页
Drug Evaluation
基金
鞘内转GLT-1基因治疗吗啡耐受的可行性和机理研究。广西自然科学基金项目
编号:2015GXNSFAA139174
关键词
氯胺酮
吗啡耐受
慢性癌痛
神经外科
疗效分析
Ketamine
Mechanisms of Morphine Tolerance
Severe Rectum Cancer Pain
Neurosurgery
Curative Effect Analysis
