摘要
目的:探讨氢吗啡酮对比吗啡皮下注射镇痛用于癌性爆发痛的临床效果和不良反应。方法:选取徐州市中心医院2019年1月至2020年12月收治的98例癌性爆发痛患者,采用随机数字表法分为氢吗啡酮皮下注射镇痛组(观察组)和吗啡皮下注射镇痛组(对照组)。比较两组患者数字分级法疼痛(NRS)评分、生活质量(QOL)评分、疼痛缓解效果、血清β-内啡肽、P物质、5-羟色胺水平以及不良反应发生情况。结果:两组患者治疗后NRS评分较治疗前均降低(均 P<0.05),治疗后观察组NRS评分低于对照组[(2.4±0.4)分比(3.2±0.5)分],差异有统计学意义( t=8.69, P<0.001);两组患者治疗后QOL评分均高于治疗前(均 P<0.05),但两组治疗后QOL评分比较[(46±7)分比(43±7)分],差异无统计学意义( t=1.62, P=0.109);观察组疼痛缓解总有效率高于对照组[93.88%(46/49)比79.59%(39/49)],差异有统计学意义( χ^(2)=4.35, P=0.037);两组患者治疗后血清β-内啡肽、P物质、5-羟色胺水平较治疗前均降低(均 P<0.05),且治疗后观察组均低于对照组[β-内啡肽(85±15)ng/L比(98±17)ng/L、P物质(2.1±0.3)μg/ml比(2.4±0.4)μg/ml、5-羟色胺(0.31±0.05)ng/L比(0.38±0.06)ng/L],差异有统计学意义( t值分别为3.75、3.63、6.27,均 P<0.05);与对照组相比,观察组皮肤瘙痒、恶心呕吐发生率更低(均 P<0.05)。 结论:与吗啡皮下注射镇痛相比,氢吗啡酮能够更好地缓解癌性爆发痛患者疼痛,同时能够降低疼痛介质水平,降低皮肤瘙痒、恶心呕吐不良反应发生率。
Objective To explore the clinical effects and adverse reactions of hydromorphone versus morphine subcutaneous injection analgesia for cancer outbreak pain.Methods A total of 98 patients with cancer outbreak pain admitted to Xuzhou Central Hospital were selected.According to the random number table method,the patients were divided into the observation group(receiving subcutaneous injection of hydromorphone for analgesia)and the control group(receiving subcutaneous injection of morphine for analgesia),49 cases in each group.The numerical rating scale(NRS)scores and quality of life(QOL)scores,pain relief effects,serumβ-endorphin,substance P,5-hydroxytryptamine levels and the incidence of adverse reactions were compared between the two groups.Results The NRS scores of the two groups after treatment were decreased compared with those before treatment(all P<0.05);and the NRS score of the observation group was lower than that of the control group after treatment[(2.4±0.4)scores vs.(3.2±0.5)scores,t=8.69,P<0.001];the QOL scores of the two groups after treatment were higher than those before treatment(all P<0.05);and there were no statistically significant difference in QOL scores after treatment between the two groups[(46±7)scores vs.(43±7)scores,t=1.62,P=0.109].The total effective rate of pain relief of the observation group was higher than that of the control group[93.88%(46/49)vs.79.59%(39/49),χ^(2)=4.35,P=0.037].The serumβ-endorphin,substance P,5-hydroxytryptamine levels of the two groups after treatment were decreased compared with those before treatment(all P<0.05).β-endorphin,substance P and 5-hydroxytryptamine of the observation group were lower than those of the control group after treatment[β-endorphin:(85±15)ng/L vs.(98±17)ng/L,substance P:(2.1±0.3)μg/ml vs.(2.4±0.4)μg/ml,5-hydroxytryptamine:(0.31±0.05)ng/L vs.(0.38±0.06)ng/L;t values were 3.75,3.63,6.27,all P<0.05).Compared with the control group,the incidence of adverse reactions like skin pruritus,nausea and vomiting of the observation grou
作者
王燕
魏玲
魏卫
陈志敏
王群
Wang Yan;Wei Ling;Wei Wei;Chen Zhimin;Wang Qun(Department of Oncology,Xuzhou Central Hospital,Xuzhou 221000,China)
出处
《肿瘤研究与临床》
CAS
2022年第2期124-127,共4页
Cancer Research and Clinic
关键词
氢吗啡酮
吗啡
癌性爆发痛
不良反应
Hydromorphone
Morphine
Cancer outbreak pain
Adverse reactions
